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Acute multilocular osteomyelitis in infancy and childhood
G Sichardt1, S Hofmann-von Kap-herr
1Klinik und Poliklinik für Kinderchirurgie, Johannes Gutenberg-Universität Mainz.
Insights
Acute multilocular osteomyelitis in infants, particularly newborns, presents unique challenges including symmetrical involvement. Close monitoring and early intervention are crucial for improving outcomes in this pediatric emergency.
Area of Science:
- Pediatric Surgery
- Pediatric Infectious Diseases
- Orthopedic Surgery
Background:
- Osteomyelitis is a bone infection requiring prompt treatment.
- Acute multilocular osteomyelitis presents distinct challenges, especially in infants.
- Distinguishing between infantile and juvenile osteomyelitis is critical due to differing prognoses.
Purpose of the Study:
- To analyze cases of acute multilocular osteomyelitis in infants treated between 1974-1986.
- To highlight the unique presentation and challenges of osteomyelitis in newborns.
- To emphasize the need for specialized monitoring and early treatment in infantile cases.
Main Methods:
- Retrospective analysis of 38 cases of acute multilocular osteomyelitis.
- Separation of infantile cases from juvenile osteomyelitis for age-specific analysis.
- Comparison of multilocular remote vs. regional involvement patterns.
Main Results:
- Distant osteomyelitis involvement was significant in infants, with 6 of 8 cases showing symmetrical patterns.
- Symmetrical involvement, previously noted only in chronic recurrent multifocal osteomyelitis (CRMO), was observed.
- Infants, predominantly newborns, faced severe complications: 3 deaths and 2 healing defects in 8 cases.
Conclusions:
- Acute multilocular osteomyelitis in infancy, especially in newborns, is a severe condition requiring urgent pediatric and surgical care.
- Symmetrical bone involvement is a notable finding in this group.
- Close monitoring, accurate diagnostics, and prompt multidisciplinary treatment are essential to improve prognosis.
Abstract:
38 cases of acute multilocular osteomyelitis out of a total of 165 osteomyelitis patients were treated between 1974 and 1986 at the Department of Paediatric Surgery and Paediatric Diseases at the University of Mainz. Osteomyelitis in infants was separated from juvenile osteomyelitis because of the different problems inherent to this disease depending upon the age; likewise, multilocular remote involvement was separated from regional multiple involvement. It was found that distant involvement is of special importance in infancy. 6 of the 8 cases in this group presented with symmetrical involvement. This interesting phenomenon is described in this article for the first time in acute multilocular osteomyelitis; so far, it was known to occur only in chronic recurrent multifocal osteomyelitis (CRMO). The infants in this group were predominantly newborn who were particularly severely handicapped by predisposing factors such as necessary intensive-care measures or surgical interventions. Our findings showed that in this age group most of the problems occurred, namely: 3 deaths and 2 healing defects in 8 children. For this reason it is imperative to effect particularly close monitoring of multilocular acute osteomyelitis in infancy. This must be considered as a paediatric and paediatric-surgical emergency requiring not only accurate diagnostic measures but also early internistic and surgical treatment to improve the prognosis of this specific disease pattern.