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Complications of suppurative arthritis and osteomyelitis in children
S Porat1, K Goitien, B S Saperia
1Department of Orthopaedic Surgery, Hadassah University Hospital, Jerusalem, Israel.
Insights
Delayed diagnosis of pediatric suppurative arthritis and osteomyelitis caused by Staphylococcus aureus can lead to severe cardiopulmonary complications. Prompt diagnosis is crucial to prevent serious outcomes like pneumonia, cardiac failure, and limb-threatening infections.
Area of Science:
- Pediatric infectious diseases
- Pediatric rheumatology
- Pediatric critical care
Background:
- Suppurative arthritis and osteomyelitis are serious pediatric infections.
- Staphylococcus aureus is a common causative pathogen.
- Early diagnosis is critical for favorable outcomes.
Observation:
- Three children presented with suppurative arthritis and osteomyelitis.
- Two patients developed severe bronchopneumonia with complications.
- One patient experienced septic pericarditis leading to cardiac failure.
Findings:
- Delayed or incorrect diagnosis led to severe cardiopulmonary complications.
- Surgical intervention, including knee disarticulation, was necessary in one case.
- Staphylococcus aureus was identified as the causative agent in all cases.
Implications:
- Highlights the critical need for timely diagnosis of pediatric bone and joint infections.
- Emphasizes the potential for severe systemic and cardiopulmonary sequelae.
- Underscores the importance of prompt and appropriate management to prevent long-term morbidity.
Abstract:
Three children with suppurative arthritis and osteomyelitis are described to emphasise that delayed or incorrect diagnosis may lead to serious cardiopulmonary complications. In two patients, bilateral bronchopneumonia developed with pneumatocoeles, pneumothorax and empyema. The other had cardiac failure from septic pericarditis. In one case, disarticulation of the knee was needed as a life-saving measure, and the other leg developed an infected pseudarthrosis of the tibia. The causative organism in each case was staphylococcus aureus and no evidence of immunodeficiency was demonstrated.