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Group B streptococcal osteomyelitis and septic arthritis. Its occurrence in infants less than 2 months old
Insights
Group B streptococcal (GBS) infections in infants can cause bone and joint issues. Early treatment with antibiotics and surgery leads to normal growth and function in affected infants.
Area of Science:
- Pediatrics
- Infectious Diseases
- Orthopedics
Background:
- Group B streptococcus (GBS) is a significant cause of late-onset infections in infants.
- GBS osteomyelitis and septic arthritis are less common than GBS meningitis but represent serious complications.
Purpose of the Study:
- To describe the clinical presentation, treatment, and outcomes of GBS osteomyelitis and septic arthritis in young infants.
- To highlight the importance of recognizing these infections for timely intervention.
Main Methods:
- Retrospective review of nine infants diagnosed with GBS osteomyelitis or septic arthritis between January 1975 and January 1978.
- Analysis of clinical signs, affected sites, treatment modalities (antibiotics, arthrotomy, bone decompression), and follow-up outcomes.
Main Results:
- Infants presented with local joint signs, often without systemic symptoms.
- Commonly affected sites included proximal humerus, proximal/distal femur, and talus.
- Treatment involved parenteral antibiotics for 2-3 weeks, with surgical intervention (arthrotomy/decompression) as needed.
- All infants demonstrated normal growth and function post-treatment.
Conclusions:
- GBS osteomyelitis and septic arthritis are treatable conditions in infants.
- Prompt diagnosis and appropriate management, including antibiotics and surgery, are crucial for favorable outcomes.
- These infections are a notable cause of late-onset GBS disease in neonates.
Abstract:
Nine infants less than 2 months of age with group B streptococcal (GBS) osteomyelitis or septic arthritis, or both, were seen from January 1975 through January 1978. The infants had local joint signs, usually in the absence of systemic signs. The bones and joints involved were equally distributed between proximal humerus and proximal and distal femur. An infant had involvement of the talus. Treatment consisted of two to three weeks of parenteral antibiotics, arthrotomy in infants with arthritis, and bone decompression in infants with osteomyelitis. Clinical follow-up showed normal growth and function of the affected joint. Of the organisms, five were typed: four were type III and one was type Ib. Group B streptococcal osteomyelitis and/or septic arthritis was the second most common late-onset GSB infection, being surpassed only by meningitis.