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[Acute osteomyelitis: epidemiology, clinical manifestations, diagnosis and treatment]
M Bueno Barriocanal1, M Ruiz Jiménez, J T Ramos Amador
1Servicio de Urgencias Pediátricas, Hospital La Paz, Madrid, España. drbuenobar@gmail.com
Insights
This study analyzed pediatric osteomyelitis cases, finding short-term intravenous antibiotic therapy effective, leading to reduced hospital stays without compromising patient outcomes. Group A Streptococcus was a common pathogen.
Area of Science:
- Pediatric Infectious Diseases
- Musculoskeletal Infections
- Epidemiology
Context:
- Osteomyelitis is a significant bone infection in children.
- Understanding its epidemiology and management is crucial for effective treatment.
- This study examines cases in a pediatric tertiary care setting.
Purpose:
- To investigate the epidemiology, clinical presentation, laboratory findings, and management of pediatric osteomyelitis.
- To evaluate the effectiveness of current treatment protocols, including short-term intravenous antibiotic therapy.
Summary:
- Retrospective and prospective review of 50 pediatric osteomyelitis cases (under 15 years) from 2000-2011.
- Common symptoms included pain, functional impairment, and fever; femur, fibula, and calcaneus were most affected.
- Group A Streptococcus was the most frequent pathogen; short-term IV antibiotic therapy resulted in shorter hospitalizations with excellent outcomes.
Impact:
- Highlights the efficacy of current short-term intravenous antibiotic regimens for pediatric osteomyelitis.
- Provides valuable epidemiological data for pediatric bone infections.
- Suggests that modern treatment protocols can lead to shorter hospitalizations without compromising recovery.
Background And Aims:
The present study focuses on the epidemiology, clinical and laboratory data, and management of osteomyelitis in a pediatric third level hospital.
Methodology:
All cases of children under 15 years-old admitted with osteomyelitis between 2000 and 2011 were retrospectively reviewed until July 2006, then prospectively from then until 2011.
Results:
A total of 50 patients were identified (52% males) with median age at diagnosis of 2 years. Principal onset manifestations were pain (94%), functional impairment (90%) and fever (72%). The femur (32%), fibula (28%) and calcaneus (22%) were most affected bones. Leucocytosis > 12.000/μl was found in 56%, elevated ESR > 20 mm/h in 26%, and elevated CRP > 20 mg/L in 64%. Blood culture was positive in 20%, with group A streptococcus being the most frequently isolated bacteria (11%). All diagnoses were confirmed by a (99)Tc scintigraphy bone scan. Antibiotic therapy was initially intravenously (mean time of administration: 10 days ± 3 SD), followed by oral medication (mean time of administration: 18 days ± 6 SD). Surgery was necessary in 3 patients. Evolution of all cases was excellent, despite 3 exceptions that resolved over time.
Conclusions:
The current short-term intravenous therapy led to shorter hospitalizations. There were no statistically significant differences between time from clinical onset or in CRP levels at discharge compared to long-term therapies prior to 2006.
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