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Published on: February 9, 2011
Paediatric case of group A streptococcal pharyngitis, arthritis and osteomyelitis associated with dental neglect
Tomohiro Hiraoka1, Taro Chujo2, Mitsuru Tsuge3
1Paediatrics, Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan tomohiro.hiraoka@gmail.com.
Insights
Dental neglect in children can lead to severe Group A Streptococcus (GAS) infections. This case report details a child with GAS pharyngitis, bacterial arthritis, and osteomyelitis linked to poor dental care.
Area of Science:
- Pediatric infectious diseases
- Child neglect and public health
Background:
- Group A Streptococcus (GAS) causes diverse pediatric infections, from pharyngitis to invasive diseases like osteomyelitis.
- Dental neglect, characterized by inadequate oral care, can lead to severe health complications, including sepsis.
Observation:
- A 4-year-old boy with documented child neglect presented with GAS pharyngitis.
- The child subsequently developed bacterial arthritis in his right ankle, osteomyelitis in the talus, and a calcaneal abscess.
Findings:
- Initial treatment with penicillin was switched to clindamycin due to a suspected drug reaction.
- The patient recovered after 6 weeks of intravenous therapy, with resolved symptoms and normalized inflammatory markers.
Implications:
- This case underscores the critical link between dental neglect and the risk of invasive GAS infections in children.
- Highlights the importance of recognizing and addressing child neglect to prevent severe sequelae.
Abstract:
Group A streptococcus (GAS) causes a wide variety of infections in the paediatric population, ranging from pharyngitis to rare but severe invasive diseases, such as bacterial arthritis and osteomyelitis. Dental neglect is a type of child neglect in which caregivers fail to provide adequate care and treatment for dental diseases. This results in poor oral hygiene and can lead to complications including sepsis. We report the case of a 4-year-old boy, suffering from child neglect, presenting with GAS pharyngitis and subsequent bacterial arthritis in the right ankle, osteomyelitis in the right talus and abscess in the right calcaneus. He was first treated with penicillin, which was changed to clindamycin because of a suspected drug-induced rash. He was discharged after 6 weeks of intravenous therapy when symptoms had resolved and inflammatory markers were within the normal range. The case highlights that dental neglect may present a risk for subsequent invasive infections.
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