Osteomyelitis in Infants and Children

Abstract

One hundred sixty-three cases of osteomyelitis in infants and children were seen at our hospital during the past 15 years. There were twice as many boys as girls. Staphylococcus aureus was the major etiologic agent, being identified in 61% of the cases. Gram-negative bacteria were responsible for only 14 cases (9%). The femur, the tibia, or the humerus were affected in 103 of the 152 patients with single bone involvement. Ostoemyelitis of more than one bone was seen in 11 cases (7%). Associated joint infectin was confirmed in 29 patients. There were no deaths. Surgical drainage was carried out in 81 cases (50%). Ten patients had recurrent or persistent drainage and one developed a Brodie abscess. Of the patients with S aureus osteomyelitis, chronic disease occurred in 19% of those receiving parenterally administered antibiotics for three weeks or less, but in only one patient (2%) of those who received parenteral antibiotics longer than three weeks.

Acute Haematogenous Osteomyelitis and Septic Arthritis in Childhood:A 10-Year Review and Follow-Up

“…aureus and, in rare cases, streptococci (Dich et al 1975 Nade et al 1974, Nade 1974a, b, Rhodes 1975. The most common causative organisms in septic arthritis are Staph.…”

“…Staph. aureus was the dominating pathogen isolated and ha1 P of the I n spite of modem treatment, skeletal infections in children often have a prolonged course and lead in some cases t o invalidity (Cole et al 1975, Dich et al 1975, Howard et al 1976 At least two of the following diagnostic criteria were met: (1) Localized tenderness, redness, swelling or reduced mobility; (2) Pus aspirated from bones or joints; (3) Growth of pathogenic bacteria from blood culture; and (4) radiological manifestations of osteomyelitis or septic arthritis. Children with radiological signs of both osteomyelitis and septic arthritis were primarily assigned the former diagnosis.…”

Primary acute haematogenous osteomyelitis of an isolated metatarsal in children

“…In the past, scant attention has been paid to primary osteomyelitis of individual metatarsals, although papers dealing with osteomyelitis in general mention it (Dich et al 1975 The association between secondary osteomyelitis of the metatarsals and puncture wounds is well known (Lang & Petersen 1976). A t our hospital about 30 new cases of acute osteomyelitis are seen each year (Blockey & Watson 1970).…”

Osteomyelitis: Approach to Diagnosis and Treatment

“…The risk of chronic infection increases unacceptably when effective therapy is given for less than 3 weeks. 16 In adults, parenteral treatment should be given for up to 6 weeks for uncomplicated cases in which no residual nidus of infection is suspected. 17 In children, acute hematogenous osteomyelitis can often be managed without surgical intervention, though the participation of surgeon in the decision-making process is advisable.…”