Pelvic Osteomyelitis in Children: A Comparison of Decades From 1980–1989 With 1990–2001

Davidson, Darin; Letts, Merv; Khoshhal, Khalid I.

doi:10.1097/01241398-200307000-00019

Cited by 38 publications

(75 citation statements)

References 31 publications

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“…2 Estudios anteriores han sugerido que el tiempo que transcurre entre el inicio de los síntomas y la hospitalización es prolongado, y que el diagnóstico a menudo se retrasa debido a la localización profunda del foco infeccioso. 2,6 El intervalo de edad de los niños con osteomielitis El hemocultivo o el cultivo del material aspirado de médula ósea pueden dilucidar el 50 % de los microorganismos causales. El Staphylococcus aureus es el microorganismo causal más frecuente (90 %), lo que es similar a la osteomielitis hematógena aguda.…”

Section: Discussionunclassified

Osteomielitis pélvica en una paciente de 15 años. Presentación de un caso

2016

Arch Argent Pediat

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RESUMENLa osteomielitis pélvica es una infección poco frecuente, que suele afectar el ilion, el isquion, el pubis y el acetábulo. La radiografía de pelvis, la resonancia magnética de pelvis y el centellograma óseo son técnicas de diagnóstico por imágenes de mucha utilidad. Sin embargo, el diagnóstico debe confirmarse con la biopsia ósea de la lesión. A veces, el diagnóstico se retrasa debido a la localización profunda del foco infeccioso. Aquí presentamos el caso de una paciente de 15 años con dolor inguinal izquierdo, con diagnóstico de osteomielitis pélvica al mes de la manifestación de los síntomas iniciales. Recibió tratamiento antibiótico durante 8 semanas, con resultados satisfactorios. En conclusión, si bien la osteomielitis pélvica es una infección inusual en la infancia, debe considerarse como diagnóstico diferencial para el dolor en la ingle, la cadera, el muslo, el abdomen y la columna. Si se sospecha este diagnóstico, es necesario comenzar el tratamiento empírico de inmediato, porque es posible lograr resultados clínicos satisfactorios con el tratamiento eficaz. Palabras clave: niños, dolor, osteomielitis pélvica aguda.http://dx.doi.org/10.5546/aap.2016.e370 INTRODUCCIÓNLa osteomielitis es una infección local del hueso frecuentemente causada por la diseminación de microorganismos hacia el hueso por vía hematógena. Entre otros factores predisponentes se incluyen la inoculación directa por traumatismos o procedimientos quirúrgicos, y la invasión local desde las partes blandas infectadas. Se calcula que la incidencia es de 1 cada 5000 a 7700 niños en los países desarrollados Osteomielitis pélvica en una paciente de 15 años. Presentación de un casoPelvic osteomyelitis in a 15-year-old girl. Case report y de 1 cada 500 a 2300 niños en los países en vías de desarrollo.1 En los niños, la osteomielitis hematógena aguda suele afectar los huesos tubulares largos.2 Es más frecuente en los varones que en las niñas, y la mayoría de los niños con osteomielitis son menores de 5 años. Si bien la osteomielitis pélvica es poco frecuente en la infancia, es una enfermedad importante por las complicaciones que puede ocasionar si no se trata.Los pacientes pueden ser hospitalizados con dolor en la cadera, muslo, abdomen o columna, y con dificultad para caminar. 4 A veces, el diagnóstico se retrasa debido a la localización profunda del foco infeccioso.2 Además, no existen signos ni síntomas clínicos específicos que permitan descartar otras enfermedades infecciosas y ortopédicas. 5En este artículo presentamos el caso de una paciente con osteomielitis pélvica que recibió el diagnóstico al mes de la manifestación de los síntomas iniciales. PRESENTACIÓN DE UN CASOUna niña de 15 años ingresó al hospital con dolor inguinal izquierdo, sin antecedentes de fiebre o traumatismo. El dolor era constante en reposo y en movimiento, no respondía a los analgésicos y había comenzado hacía un mes atrás, aproximadamente. La paciente no presentaba dolor en el lado derecho de la cadera y la ingle; el dolor inguinal era más intenso del lado izqu...

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Section: Discussionunclassified

Osteomielitis pélvica en una paciente de 15 años. Presentación de un caso

2016

Arch Argent Pediat

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“…2 Previous studies suggested that time between the onset of symptoms and admission to hospital is so long and diagnosis is often delayed due to deep localization of the infection site. 2,6 Age spectrum of children with pelvic osteomyelitis is older than children with acute hematogenous osteomyelitis. 7 Although pelvic osteomyelitis is more commonly seen in boys, male/female ratio is lower than acute hematogenous osteomyelitis (1.5/1).…”

Section: Discussionmentioning

confidence: 99%

Pelvic osteomyelitis in a 15-year-old girl. Case report

2016

Arch Argent Pediat

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Pelvic osteomyelitis is a rare infection. Ilium, ischium, pubis and acetabulum are commonly affected sites. Pelvic radiography, pelvic magnetic resonance and scintigraphy are useful imaging techniques for diagnosis. However, diagnoses should be confirmed with bone biopsy from the lesion. Sometimes diagnosis is delayed because of deep localization of infection site. Here in, we report a 15-year-old girl with left groin pain who was diagnosed as pelvic osteomyelitis one month after initial symptoms. Patient was successfully treated with antibiotics for 8 weeks. In conclusion, although pelvic osteomyelitis is an unusual infection in childhood, it should be considered as differential diagnoses of pain in groin, hips, thigh, abdomen and spine. If diagnosis is suspicious, empiric treatment should be started quickly, because it will be possible to achieve satisfactory clinical results with effective treatment.

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“…1 It is difficult to diagnose because of the rarity of infection and difficulty localizing the site of infection. Common misdiagnoses include septic arthritis or synovitis of the hip, appendicitis, cellulitis, pelvic inflammatory disease and nephrolithiasis.…”

Section: Discussionmentioning

confidence: 99%

“…4 Common laboratory findings include an elevated ESR and CRP as well as an elevated white blood cell count, however, the diagnosis should not be excluded based on normal laboratory values. 1,3 The most frequently recovered organisms are Staphylococcus aureus with up to 50% of cultures being negative.…”

Section: Discussionmentioning

confidence: 99%

“…Other complications that have been reported include fusion of the sacroiliac joint and deep vein thrombosis in a protein-Cdeficient patient. 1 Persistent infection due to chronic osteomyelitis or chronic recurrent multifocal osteomyelitis generally resolves with long-term antibiotics. Follow up should be long enough to identify complications such as growth abnormalities and chronic recurrent infections.…”

Section: Discussionmentioning

confidence: 99%

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Pseudomonas Pelvic Osteomyelitis in a Healthy Child

Akhras¹,

Blackwood²

2011

Infectious Disease Reports

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Pediatric pelvic osteomyelitis is a rare entity. The diagnosis is frequently delayed due to difficulty in confirming the diagnosis. To our knowledge, this is the first case report of Pseudomonas pelvic osteomyelitis in a previously healthy adolescent boy. The diagnosis was made radiographically and confirmed by culture. The patient was treated with Levofloxacin and Gentamicin resulting in a complete recovery. Case ReportA previously healthy 13-year-old boy presented to an outside institution with two months of pain that started in the posterior of his left leg and slowly progressed until the pain encompassed the entire pelvis. He was an avid athlete but had no history of trauma. He had intermittent fevers with maximum temperature of 102° F. A white blood cell count at initial presentation was 12.4¥10 9 /L and an MRI demonstrated a partial tendon tear with strain in the left obturator adductor, minimus and magnus with no bone involvement. Radiographs of the pelvis and femur were negative. A diagnosis of a torn tendon was made and treatment with non-steroidal anti-inflammatory medications was initiated. Pain continued to progress eventually involving the entire lower abdomen. Creactive protein and Erythrocyte Sedimentation Rate were elevated at 13.6 mg/L and 113 mm/hour one month into treatment. Computerized Tomography (CT) scan of the abdomen and pelvis with oral and intravenous contrast was negative and a tagged white blood cell scan at six weeks was also negative.Two months after the initial presentation, the patient was hospitalized for continued pain and a 20-lb weight loss. On admission, the patient was afebrile but exhibited significant pelvic discomfort. Exam of the head, neck, chest and abdomen revealed no abnormalities. Musculoskeletal exam showed decreased flexion at the right knee with moderately decreased internal rotation of the right hip. There was severe tenderness with palpation over the right buttock and right ischial spine.No fluctuance or overlying skin changes. The patient could not bear full weight on his right leg. Bilateral femur and pelvic radiographs showed focal demineralization surrounding the left hip. Focal periostitis was seen on the left ischium and left inferior pubic ramus. Bone scintigraphy showed increased blood flow, blood pool and delayed radiotracer uptake primarily involving the right ischium and posterior aspect of the right inferior pubic ramus.

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Pelvic Osteomyelitis in Children: A Comparison of Decades From 1980–1989 With 1990–2001

Cited by 38 publications

References 31 publications

Osteomielitis pélvica en una paciente de 15 años. Presentación de un caso

Osteomielitis pélvica en una paciente de 15 años. Presentación de un caso

Pelvic osteomyelitis in a 15-year-old girl. Case report

Pseudomonas Pelvic Osteomyelitis in a Healthy Child

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