Neonatal osteomyelitis in Nigerian infants

Abstract

Twenty-seven Nigerian infants with osteomyelitis during the first 28 days of life are presented to highlight the severity of the clinical manifestations and the radiological features of this infection. The clinical signs include limitation of movement of the extremities involved and localized swelling. Severe constitutional changes such as fever (greater than 39 degrees C) and abdominal distension were common. This contrasts with results from North America and Europe which emphasize the paucity of clinical signs despite involvement of multiple sites. Multiple site involvement was encountered in only eight cases. Staphylococcus aureus, proteus mirabilis and candida albicans were the main pathogens isolated. The long bones were more frequently affected. Aggressive bone destruction was a constant radiological finding peculiar to staphylococcal osteomyelitis while the formation of sequestrum, a rare occurrence in the newborn, was present in six patients. The mortality rate was 7.4% and the morbidity rate was equally low.

Candida albicans osteomyelitis in an infant

“…neonates and infants likely developed osteomyelitis as a complication of hematogenously disseminated candidiasis during their NICU hospitalization [1][2][3][4][5][6][7][8][9][10][11][12][15][16][17]19]. The only three patients described outside infancy either had an immunodeficiency, MPO deficiency, which is a known risk factor for severe Candida infection, prolonged steroid therapy, or recent trauma [13,14,18].…”

Acute osteomyelitis as cause of late sepsis in a Nigerian neonate

“…Neonatal bone and joint infection are said to be infrequent and uncommonly reported in the sub-region. [ 1 ] The first few medical literatures from Nigeria dated back to about three decades ago[ 1 2 3 4 ] and since then there has been a paucity of reports on this disease from the sub-region. Although the rarity may be true, either because the cases are under-diagnosed, unreported or under reported.…”