Microbiological Culture Methods for Pediatric Musculoskeletal Infection

Section, Jarren; Gibbons, Steven D.; Barton, Theresa; Greenberg, David E.; Jo, Chan Hee; Copley, Lawson A.

doi:10.2106/jbjs.n.00477

Cited by 62 publications

(64 citation statements)

References 17 publications

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“…30 Recently, the addition of polymerase chain reaction and other molecular diagnostics recently has significantly increased positive results. 31 Specimens should also be sent for histopathology as childhood malignancies can present similarly.…”

Section: Epidemiologymentioning

confidence: 99%

Paediatric bone and joint infection

Iliadis

Ramachandran

2017

EFORT Open Reviews

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Despite advances in understanding and management, paediatric osteoarticular infections continue to pose diagnostic difficulties for clinicians. Delays in diagnosis can lead to potentially devastating morbidity.No single investigation, including joint aspiration, is sufficiently reliable to diagnose conclusively paediatric bone and joint infection. Diagnosis should be based on a combination of clinical signs, imaging and laboratory investigations. Algorithms should supplement, and not replace, clinical decision making in all cases.The roles of aspiration, arthrotomy and arthroscopy in the treatment of septic arthritis are not clearly defined. There is a very limited role for surgery in the management of acute haematogenous osteomyelitis.The ideal duration and mode of administration of antibiotic therapy for osteoarticular paediatric infection is not yet fully defined but there is increasing evidence that shorter courses (three weeks) and early conversion (day four) to oral administration is safe and effective in appropriate cases. Clear and concise antibiotic guidelines should be available based on local population characteristics, pathogens and their sensitivities.Kingella kingae is increasingly identified through polymerase chain reaction and is now recognised as the commonest pathogen in children aged under four years. Methicillin-resistant Staphylococcus aureus and Panton-Valentine leukocidin-producing strains of Staph. aureus are being increasingly reported.A multidisciplinary integrated evidence-based approach is required to optimise outcomes.Further large-scale, multicentre studies are needed to delineate the optimal management of paediatric osteoarticular infection. Cite this article: EFORT Open Rev 2017;1:7-12. DOI: 10.1302/2058-5241.2.160027.

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Section: Epidemiologymentioning

confidence: 99%

Paediatric bone and joint infection

Iliadis

Ramachandran

2017

EFORT Open Reviews

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“…Furthermore, the prevalence of K kingae seems to vary geographically, perhaps accounting in part for our findings. 6,[30][31][32][33] Continued surveillance of the microbiology of AHO is needed to inform empirical therapy in the future.…”

Section: Figurementioning

confidence: 99%

Role of Operative or Interventional Radiology-Guided Cultures for Osteomyelitis

et al. 2016

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BACKGROUND AND OBJECTIVE: Acute hematogenous osteomyelitis (AHO) is a severe infection in children. Drainage of purulent collections in bones provides specimens for culture as well as therapeutic benefit. Interventional radiology (IR)-guided procedures may serve as a less invasive means of culture in select patients. We examined the impact of IR and surgically obtained cultures in the diagnosis and management of AHO.

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“…Blood cultures are often negative. 5 Definitive diagnosis relies on radiologic imaging, specifically MRI, which shows the early signs of muscular inflammation and involvement of adjacent bone structures. 6 Ultrasonography can be a useful first diagnostic test but is not sensitive in the early stages or in cases with deeper muscular involvement.…”

Section: Discussionmentioning

confidence: 99%