Acute osteomyelitis and septic arthritis in children : A referral hospital-based study in Iran
Shima Mahmoudi1, Babak Pourakbari1, Katayoun Borhani2
1Pediatric Infectious Diseases Research Center, Tehran University of Medical Sciences, No. 62, Dr. Gharib St., Tehran, Iran.
Insights
Pediatric osteomyelitis (OM) and septic arthritis (SA) are common, with Staphylococcus aureus being the primary pathogen. Prompt diagnosis of these infections, especially when occurring concurrently, is crucial for effective treatment in children.
Area of Science:
- Pediatric infectious diseases
- Musculoskeletal infections
- Epidemiology
Background:
- Limited epidemiological data exists for acute osteomyelitis (OM), septic arthritis (SA), and concurrent OM and SA in children.
- Understanding the incidence and patterns of these pediatric infections is essential for public health and clinical management.
Purpose of the Study:
- To describe the epidemiology of osteomyelitis (OM), septic arthritis (SA), and concurrent OM and SA in a pediatric population.
- To identify common pathogens, affected sites, and clinical characteristics associated with these infections.
Main Methods:
- Retrospective analysis of pediatric patients admitted to Children's Hospital, Tehran, Iran over a 4-year period.
- Inclusion criteria: patients diagnosed with OM and/or SA.
- Data collection included patient demographics, clinical findings, laboratory results, and microbiological data.
Main Results:
- A total of 111 patients with OM and/or SA were identified out of 63,999 admissions.
- Incidence rates were 11 cases per 10,000 children for both OM and SA.
- Concurrent OM and SA occurred in 0.17% of cases (n=51). Staphylococcus aureus was the most frequent pathogen. Lower limb and hip/knee joints were most commonly affected.
Conclusions:
- The study highlights a significant frequency of concurrent septic arthritis and osteomyelitis in pediatric patients.
- Elevated erythrocyte sedimentation rate and C-reactive protein were common findings.
- Emphasizes the critical need for prompt recognition and accurate diagnosis of pediatric OM and SA.
Abstract:
Information concerning the epidemiology of acute osteomyelitis (OM), septic arthritis (SA) and concurrent OM and SA in children is limited. The aim of this study was to describe the epidemiology of OM, SA and concurrent OM and SA in children. During the 4 years of the study, 63,999 patients were admitted to the Children's Hospital, Tehran, Iran. We identified 111 patients with OM and/or SA during the 4‑year period. There were 72 cases of OM (11 cases per 10,000 children) and 90 cases of SA (11 cases per 10,000 children). Concurrent OM and SA accounted for 0.17% of all cases (n = 51). The erythrocyte sedimentation rate and C‑reactive protein were elevated in the majority of both infections. Staphylococcus aureus was the most frequent pathogen responsible for both OM and SA in any age group. The lower limb was the most frequently affected (femur: 33/72, 46%; tibia or fibula: 22/72, 31%; foot: 5/72, 7%). The most frequent involved joints were hips (n = 31, 34%) and knees (n = 31, 34%). The present study showed high frequency of patients with concurrent SA and OM. Therefore, prompt recognition and proper diagnosis of pediatric OM and SA is highly recommended.
