Challenges in managing paediatric osteomyelitis in the developing world: Analysis of cases presenting to a tertiary referral centre in Tanzania

Ali, Adam M.; Maya, Elisfuraha; Lakhoo, Kokila

doi:10.4103/0189-6725.143136

Cited by 22 publications

(22 citation statements)

References 7 publications

(9 reference statements)

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“…As shown in previous studies, the tibia is the most commonly affected bone [2, 6, 10, 14, 26] followed by the femur and the humerus. The tibia also had the most number of bone defects (B4 classifications) (Fig.…”

Section: Resultsmentioning

confidence: 74%

“…The accurate documentation of follow-up is variable. Inconsistent follow-up is highlighted in another recent study that had a 47 % rate of patients who failed to attend follow-up [14]. …”

Section: Resultsmentioning

confidence: 99%

“…The specific role and mode of delivery of antibiotics in treatment remains a matter for debate. Some authors advocate antibiotics should be used routinely [2, 6, 10, 12–14], and others advocate that they should be used selectively or when patients are systemically unwell [1–4]. Opinion on the appropriate strategies for the treatment of bone defects also remains diverse and is often influenced by surgical experience and availability of resources [1, 17, 20–23].…”

Section: Introductionmentioning

confidence: 99%

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The Beit CURE Classification of Childhood Chronic Haematogenous Osteomyelitis—a guide to treatment

et al. 2015

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BackgroundThe Beit CURE (BC) classification is a radiographic classification used in childhood chronic haematogenous osteomyelitis. The aim of this study is to assess correlation between this classification and the type and extent of treatment required.MethodsWe present a retrospective series of 145 cases of childhood chronic haematogenous osteomyelitis classified using the BC classification. Variables measured include age, sex, bone involved, number of admissions, length of stay, type/number of operations and microbiology.ResultsThe most commonly affected bone was the tibia (46 %), followed by femur (26 %) and humerus (10 %). Bone defects were most common in the tibia. Staphylococcus aureus was the most commonly isolated organism.Type B, sequestrum type, was the most common (88 %), followed by type C, sclerotic type, (7 %) and type A, Brodie’s abscess (5 %).Types A and B1 had the shortest length of hospitalisation (11 days), type B4 had the longest (87 days). Types A and B1 had the fewest infection control operations. Type B4 had the greatest total number of operations.ConclusionsThis study shows that the BC classification can guide surgical strategy and help predict length of inpatient treatment and number and type of procedures required.

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Section: Resultsmentioning

confidence: 74%

“…The accurate documentation of follow-up is variable. Inconsistent follow-up is highlighted in another recent study that had a 47 % rate of patients who failed to attend follow-up [14]. …”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Beit CURE Classification of Childhood Chronic Haematogenous Osteomyelitis—a guide to treatment

et al. 2015

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“…In addition to the above-mentioned etiologic factors, cranial osteomyelitis is influenced by systemic diseases that decrease bone vascularity, the course of illness, and alter the host defense mechanism. [ 12 22 48 49 50 51 52 53 54 55 56 57 58 ] The causative infections and predisposing comorbidities are summarized in Table 1 .…”

Section: Discussionmentioning

confidence: 99%

A comprehensive review of skull base osteomyelitis: Diagnostic and therapeutic challenges among various presentations

Khan¹,

Quadri²,

et al. 2018

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Skull base osteomyelitis (SBO) is a complex and fatal clinical entity that is often misdiagnosed for malignancy. SBO is commonly a direct complication of otogenic, sinogenic, odontogenic, and rhinogenic infections and can present as central, atypical, or pediatric clival SBO. This review describes the clinical profile, investigational approach, and management techniques for these variants. A comprehensive literature review was performed in PubMed, MEDLINE, Research Gate, EMBASE, Wiley Online Library, and various Neurosurgical and Neurology journals with the keywords including: SBO, central or atypical SBO, fungal osteomyelitis, malignant otitis externa, temporal bone osteomyelitis, and clival osteomyelitis. Each manuscript's reference list was reviewed for potentially relevant articles. The search yielded a total of 153 articles. It was found that with early and aggressive culture guided long-term intravenous broad-spectrum antibiotic therapy decreases post-infection complications. In cases of widespread soft tissue involvement, an early aggressive surgical removal of infectious sequestra with preferentially Hyperbaric Oxygen (HBO) therapy is associated with better prognosis of disease, less neurologic sequelae and mortality rate. Complete resolution of the SBO cases may take several months. Since early treatment can improve mortality rates, it is paramount that the reporting radiologists and treating clinicians are aware of the cardinal diagnostic signs to improve clinical outcomes of the disease. It will decrease delayed diagnosis and under treatment of the condition. However, due to rarity of the condition, complete prognostic factors have not fully been analyzed and discussed in the literature.

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“…12 Result of our study about the common site of chronic infection was similar with Kubwimana study that reported tibia with frequency 35% because tibia is subcutaneous anteriorly and not fully covered by muscles and thus more prone to open fractures. 13,14 This study had certain limitations, for example, diabetic foot infection cases were not treated at the departments, and complete follow-up data was not available, which impacted the observation of the overall distribution of osteomyelitis. Information about the influential factors was incomplete.…”

Section: Discussionmentioning

confidence: 99%

Epidemiologic study of chronic osteomyelitis in Paktya and Kabul, Afghanistan

Oryakhil

Bismellah

2020

Int J Res Med Sci

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Background: Osteomyelitis is an infection of the bone that can occur from direct or indirect invasion by a pathogens, both of these types can potentially progress to subacute and chronic osteomyelitis that lasts longer than 4 weeks. This disease has important characteristics such as long-term clinical course, long periods of silence, the treatment of the recurrence of serious complications of the disease is difficult financially and it takes a lot of money epidemiology of chronic osteomyelitis in the Afghanistan is largely unknown. The aim of this study was epidemiologic study of chronic osteomyelitis in adult clients of Paktya city regional hospital and Wazir Akbar Khan Hospital in Kabul city of Afghanistan.Methods: This descriptive cross-sectional study was performed in patients' with chronic osteomyelitis who referred in this two hospitals in Paktya city regional hospital and the Wazir Akbar Khan hospital in Kabul During the March 2019 to March 2020, 70 patients were identified with chronic osteomyelitis. The information required for the study, such as general information, underlying diseases of the patients collected from these two medical centers. After encoding, the necessary information was entered into the computer and analyzed.Results: According to the findings of this study the prevalence of chronic bone infections in male were 64% (n=45) in female were 36% (n=25), current findings showed 44.3% of all patient involved with tibial (n=31) chronic osteomyelitis and the most common underlying disease causing chronic osteomyelitis is the direct entry of infection as a result of trauma.Conclusions: Our study showed the chronic osteomyelitis is higher in the male population than in the female population and highest incidence of chronic osteomyelitis site was tibia result of trauma because of humid climate, poor personal and hospital environmental health status and relatively poor medical facilities in Afghanistan may contribute to higher morbidity.

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Challenges in managing paediatric osteomyelitis in the developing world: Analysis of cases presenting to a tertiary referral centre in Tanzania

Cited by 22 publications

References 7 publications

The Beit CURE Classification of Childhood Chronic Haematogenous Osteomyelitis—a guide to treatment

The Beit CURE Classification of Childhood Chronic Haematogenous Osteomyelitis—a guide to treatment

A comprehensive review of skull base osteomyelitis: Diagnostic and therapeutic challenges among various presentations

Epidemiologic study of chronic osteomyelitis in Paktya and Kabul, Afghanistan

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