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Differentiation of Deep Venous Thrombosis Among Children With or Without Osteomyelitis

John A Ligon1, Janna M Journeycake2, Shellie C Josephs3

  • 1Department of Hematology/Oncology, Johns Hopkins Hospital, Baltimore, MD.

Journal of Pediatric Orthopedics
|August 7, 2018
PubMed

Insights

Children with deep venous thrombosis (DVT) and osteomyelitis have distinct characteristics, often lacking comorbidities. Early recognition of these differences in pediatric DVT cases is crucial for timely diagnosis and management.

Area of Science:

  • Pediatric Thrombosis Research
  • Infectious Disease Epidemiology
  • Vascular Health in Children

Background:

  • Children with osteomyelitis face an increased risk of deep venous thrombosis (DVT).
  • This study aimed to identify specific characteristics of DVT in pediatric patients to distinguish those with and without osteomyelitis.

Purpose of the Study:

  • To compare the clinical characteristics and outcomes of pediatric deep venous thrombosis (DVT) in children with and without osteomyelitis.
  • To identify differentiating factors for DVT in children with osteomyelitis.

Main Methods:

  • Retrospective cohort comparison of children with DVT (2008-2016).
  • Comparison groups included children with DVT and osteomyelitis, DVT without osteomyelitis, and osteomyelitis without DVT.
  • Analysis focused on comorbidities, severity of illness (SOI), and clinical course.

Main Results:

  • Children with DVT and osteomyelitis exhibited higher severity of illness, bacteremia rates, methicillin-resistant Staphylococcus aureus (MRSA) prevalence, and intensive care unit admissions compared to those without osteomyelitis.
  • Unlike children with DVT without osteomyelitis, those with concurrent osteomyelitis typically lacked comorbidities or hypercoagulability.
  • Pulmonary embolism rates were similar between the two DVT groups.

Conclusions:

  • Pediatric DVT in the context of osteomyelitis is characterized by the absence of comorbidities and a more severe clinical presentation, including higher rates of MRSA and intensive care needs.
  • Distinguishing DVT in children with osteomyelitis from other pediatric DVT cases is essential for prompt diagnosis via ultrasound and optimized anticoagulation management, considering frequent surgical interventions.
Abstract

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