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Joint and bone infections due to anaerobic bacteria in children
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This review covers anaerobic bacterial infections in children, focusing on septic arthritis and osteomyelitis. While rare, these infections require specific diagnosis and management strategies, including appropriate antibiotic therapy.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Bacterial Pathogenesis
Background:
- Septic arthritis and osteomyelitis are common pediatric infections, typically caused by aerobic bacteria.
- Anaerobic bacterial involvement in these pediatric conditions is infrequently reported but clinically significant.
Purpose of the Study:
- To review the microbiology, diagnosis, and management of septic arthritis and osteomyelitis caused by anaerobic bacteria in children.
- To highlight the distinct characteristics and treatment approaches for anaerobic versus aerobic bone and joint infections in pediatric populations.
Main Methods:
- Literature review of existing studies on pediatric septic arthritis and osteomyelitis.
- Analysis of microbiological data, diagnostic challenges, and treatment outcomes for anaerobic infections.
Main Results:
- Predominant aerobic pathogens include Staphylococcus aureus, Haemophilus influenzae type-b, and streptococci.
- Anaerobic arthritis is often monomicrobial and secondary to hematogenous spread, while osteomyelitis may stem from concurrent anaerobic infections elsewhere.
- Common anaerobic culprits include Bacteroides fragilis group, Fusobacterium, Clostridium, and Peptostreptococcus species.
Conclusions:
- Anaerobic septic arthritis and osteomyelitis in children are rare but necessitate specific diagnostic and therapeutic considerations.
- Effective management involves symptomatic care, drainage, and targeted antibiotic therapy effective against anaerobic organisms.
Abstract:
The current review describes the microbiology, diagnosis and management of septic arthritis and osteomyelitis due to anaerobic bacteria in children. Staphylococcus aureus, Haemophilus influenzae type-b, and Group A streptococcus, Streptococcus pneumoniae, Kingela kingae, Neisseria meningiditis and Salmonella spp are the predominant aerobic bacteria that cause arthritis in children. Gonococcal arthritis can occur in sexually active adolescents. The predominant aerobes causing osteomyelitis in children are S. aureus, H. influenzae type-b, Gram-negative enteric bacteria, beta-hemolytic streptococci, S. pneumoniae, K. kingae, Bartonella henselae and Borrelia burgdorferi. Anaerobes have rarely been reported as a cause of these infections in children. The main anaerobes in arthritis include anaerobic Gram negative bacilli including Bacteroides fragilis group, Fusobacterium spp., Clostridium spp. and Peptostreptococcus spp. Most of the cases of anaerobic arthritis, in contrast to anaerobic osteomyelitis, involved a single isolate. Most of the cases of anaerobic arthritis are secondary to hematogenous spread. Many patients with osteomyelitis due to anaerobic bacteria have evidence of anaerobic infection elsewhere in the body, which is the source of the organisms involved in osteomyelitis. Treatment of arthritis and osteomyelitis involving anaerobic bacteria includes symptomatic therapy, immobilization in some cases, adequate drainage of purulent material and antibiotic therapy effective to these organisms.