Microbiological profile of haematogenous osteoarticular infections in children

Trifa, Mehdi; Bouchoucha, Sami; Smaoui, H.; Frikha, M.; Marzouk, S. Ben; Ghachem, Maher Ben; Kechrid, A.; Hassen, A. Fekih; Khalifa, S. Ben

doi:10.1016/j.otsr.2010.10.005

Cited by 9 publications

(4 citation statements)

References 26 publications

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“…Staphylococcus aureus remains the most common cause of osteomyelitis [1–4], and because this patient's presentation was associated with a paronychia, empiric therapy was directed against this organism. Empiric treatment for S. aureus is a commonly used approach when no microbiological data is available or cultures yield no growth.…”

Section: Discussionmentioning

confidence: 99%

An 11-Year-Old Male with Refractory Osteomyelitis

Mauriello

Raustol²,

Aguiar³

et al. 2012

Case Reports in Pediatrics

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We present a case of empirical treatment failure for chronic osteomyelitis in a previously healthy 11-year-old male involving the distal phalanx of the right first digit. After initial debridement, empiric antibiotics were started for presumed Staphylococcus aureus infection. Operative bacterial cultures yielded no growth. Despite three weeks of antistaphylococcal antibiotics the patient's symptoms worsened and the destruction of bone progressed. A repeat plain X-ray revealed a new lesion in the proximal phalanx of the right second digit. The recognition of multifocal osteomyelitis led to reexamination of bone tissue specimens using special stains which demonstrated rare broad-based budding yeast. Fungal cultures eventually grew Blastomyces dermatitidis. Treatment with amphotericin B led to rapid clinical improvement. This case illustrates that clinicians must remain vigilant for warning signs that empiric treatment may be failing for presumptive Staphylococcus aureus, provoking reconsideration of the differential diagnosis and an intensification of efforts to evaluate for alternative etiologies.

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Section: Discussionmentioning

confidence: 99%

An 11-Year-Old Male with Refractory Osteomyelitis

Mauriello

Raustol²,

Aguiar³

et al. 2012

Case Reports in Pediatrics

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“…12 Depending on the study, peak age of infection ranges from less than 2 years to 6 years, with isolated septic arthritis and K kingae infections occurring at younger ages, and osteomyelitis and S aureus occurring at older ages. 5,9,[12][13][14] Clinical correlation (Fig. 3) -Distribution of osteoarticular infections.…”

Section: Prevalence/incidencementioning

confidence: 99%

“…3) -Distribution of osteoarticular infections. 6,7,[13][14][15][16][17] Overall, more than 80% of osteoarticular infections occur in the lower extremities.…”

Section: Prevalence/incidencementioning

confidence: 99%

Osteoarticular Infections in Children

Arnold

Bradley

2015

Infectious Disease Clinics of North America

134

118

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“…In the case presented here, blood cultures were not part of the diagnostic process, and while these can support the diagnosis of haematogenous osteomyelitis in the dog, in two studies conducted in human beings suffering from haematogenous osteomyelitis, only 38.5 per cent and 24.4 per cent, respectively, were positive for bacterial growth on blood cultures (Sreenivas and others 2011, Trifa and others 2011). Due to the chronic nature and slow development of the lesions and subsequent clinical signs, cultures from the uterus were not available at the time the bitch presented; however, in the light of other reports describing haematogenous osteomyelitis from a uterine disease, the absence of other infectious factors and the clinical history, it is very likely that the source of haematogenous spread was the diseased uterus (Walker and others 2012, Majoy and others 2013).…”

Section: Discussionmentioning

confidence: 51%

Polyostotic osteomyelitis following open pyometra in a dog

Yanai¹,

Jakovljevic²,

Dye³

et al. 2015

Vet Record Case Reports

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A six-year-old female neutered Löwchen with a clinical history of ovariohysterectomy following open pyometra was referred for evaluation of severe progressive generalised lameness in all four limbs, of varying degrees of severity and pyrexia that developed over the two weeks following surgery. Physical examination revealed enlarged superficial cervical lymph nodes, pain on deep palpation of both humeri and a grade I/VI cardiac murmur. Radiographs demonstrated irregular solid periosteal new bone involving the diaphyses of the humeri, femora and several ribs. Serum biochemistry showed mildly decreased urea levels and mildly elevated alkaline phosphatase. Haematology revealed mild thrombocytosis. A preliminary diagnosis of osteomyelitis was made. Biopsies of the bone lesions were taken, and bacteriological cultures with susceptibility testing confirmed a diagnosis of Escherichia coli. Following six weeks of medical treatment with meloxicam, tramadol and marbofloxacin, the clinical signs resolved and follow-up radiographs obtained 12 weeks from initial presentation supported the resolution of the clinical signs. To the authors’ knowledge, this is the first reported case of haematogenous osteomyelitis presumably spreading from the uterus, involving multiple bones and leading to complete resolution with medical treatment.

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Microbiological profile of haematogenous osteoarticular infections in children

Abstract: II, prospective descriptive prognostic study.

Cited by 9 publications

References 26 publications

An 11-Year-Old Male with Refractory Osteomyelitis

An 11-Year-Old Male with Refractory Osteomyelitis

Osteoarticular Infections in Children

Polyostotic osteomyelitis following open pyometra in a dog

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