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Osteomyelitis in limb amputated by amniotic band sequence.
Mohsin Raj Mantoo1, Mayank Priyadarshi1, Ankit Verma1
1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
BMJ Case Reports
|April 17, 2019
Summary
A preterm neonate with limb defects experienced a tibial stump infection. Prompt antibiotic treatment successfully managed the osteomyelitis, allowing for discharge.
Area of Science:
- Neonatal care
- Pediatric surgery
- Infectious diseases
Background:
- Amniotic band sequence can cause congenital limb abnormalities, including amputations and constrictions.
- Preterm neonates with congenital anomalies are at increased risk for complications.
- Limb stump infections pose a significant challenge in neonatal care.
Observation:
- A preterm neonate (30+2 weeks) with a below-knee amputation, constriction rings, and syndactyly presented with pus discharge from the tibial stump.
- Clinical signs of systemic sepsis and positive blood cultures were absent.
- Pus culture identified methicillin-resistant coagulase-negative Staphylococcus.
Findings:
- Bone scan indicated osteomyelitis of the right proximal tibial stump.
- Infection was likely a contiguous spread from the exposed stump.
- The neonate received 4 weeks of intravenous antibiotics followed by oral medication.
Implications:
- Early identification and targeted antibiotic therapy are crucial for managing osteomyelitis in neonates with congenital anomalies.
- This case highlights the importance of vigilant stump care in neonates with limb malformations.
- Successful management of stump osteomyelitis can lead to favorable outcomes, enabling discharge.
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