Salmonella osteomyelitis is an uncommon pathological condition. Usually, it is associated with hemoglobinopathies or other underlying disorders. Osteomyelitis due to Salmonella is extremely rare in a previously healthy patient. We present a case of a 12-year-old previously healthy male who suffered Salmonella osteomyelitis of the proximal tibia as well as the diagnostic algorithm and therapy protocol. In our case, Salmonella osteomyelitis was identified by direct inoculation of the sample in blood culture bottles. Traditional cultures were negative. The practice of blood culture bottles seems to be essential for diagnosis, so the appropriate treatment is performed.
Pyomyositis is a rare bacterial infection that used to prevail in tropical areas for the past century. Nowadays though, more and more cases are reported in high-temperature climate areas. Diagnosis is often delayed due to the variance in clinical presentation, the challenging nature of physical examination of a child, and lack of specific laboratory investigating tools. When the diagnosis is delayed, the outcome may be unpredictable. Multifocal localization through hematogenous or direct spread that may affect the skeletal bone tissue is common. Timely diagnosis and response is a race against septic shock.
We present a case series of seven children diagnosed with pyomyositis due to Staphylococcus aureus. High or less clinical suspicion has obviously affected the final outcome since two patients who were not treated in time were subjected to a life-threatening hazard. Five patients who were diagnosed and treated within the first three days after initiation of their symptoms had a predictable and good outcome without complications.
Congenital constriction ring syndrome (CCRS) is a well-described pathological entity that is caused by fibrous bands that entrap parts of the fetus. The manifestations of this syndrome may vary a lot. We present a case of an almost intrauterine amputation of a fetus’s upper limb. Our case is infrequent because the constriction band caused a fracture of the fetus's forearm during pregnancy. Both the band and the fracture resulted in ischemia to the hand and a salvage procedure was applied after birth.
Not many authors have reported fractures due to constriction ring bands and even less have reported fractures of the upper limb. A literature review of this rare entity was conducted.
Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome is a rare disease; however, more and more case reports have been published that increase the awareness of this disorder, especially in children. Clinically it presents as a combination of chronic recurrent multifocal osteomyelitis symptoms and skin manifestations. SAPHO treatment remains a challenge. In most cases, non-steroidal anti-inflammatory drugs are initially used, although a combination with other drugs is preferred. In addition, antibiotics, corticosteroids, bisphosphonates, and disease-modifying anti-rheumatic drugs are usually administered with varied success. There are also promising results from novel biological therapy. This paper emphasizes some non-specific symptoms of the disease, in order to increase the suspicion of SAPHO in all pediatric clinical doctors. We present the case of a 13-year-old boy with severe acne, who was admitted to our hospital due to fever of unknown origin, accompanied by arthralgia of the right ankle and left knee.
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