C Lemaître, A Ferroni, C Doit, H Vu-Thien, C Glorion, J Raymond, P Mary, P Wicart, E Bingen, B Ilharreborde, M Lorrot
Streptococcus pneumoniae is an uncommon cause of osteoarticular infections (OAI) in children. The objective of this study was to investigate the clinical and laboratory characteristics of pneumococcal OAI before and after the introduction of the heptavalent pneumococcal conjugate vaccine (PCV7). Data were retrospectively collected from children aged <16 years who were hospitalized for pneumococcal OAI between 1997 and 2007 in four Parisian teaching hospitals. Forty-three children were included (32 with arthritis and 11 with osteomyelitis) and the median age of these children was 12...
October 2012: European Journal of Clinical Microbiology & Infectious Diseases
Erin N Menne, Rona Yoffe Sonabend, Edward O Mason, Linda B Lamberth, Wendy A Hammerman, Charles G Minard, Sheldon L Kaplan, Kristina G Hulten
OBJECTIVES: To describe Staphylococcus aureus infections in children with diabetes mellitus (DM). METHODS: Children with DM (cases) and S. aureus infections (2/02-6/10) were identified from a surveillance database. Patient charts were reviewed, and S. aureus isolates were characterized by molecular methods. Cases were compared to age-matched controls without DM but with CA-S. aureus skin and soft tissue infections (SSTI) using conditional logistic regression. RESULTS: Forty-seven cases were identified; 41 were matched with 123 controls...
August 2012: Journal of Infection
Camilo Jaimes, Mauricio Jimenez, Nogah Shabshin, Tal Laor, Diego Jaramillo
Pediatric stress injuries result from a mismatch between (a) the burden of activity on growing bone and cartilage and (b) their intrinsic biomechanical properties. Although the presentation of stress injuries varies with the specific physical activity and the site of injury, in children it varies primarily with the degree of skeletal maturation. During the past several years, there has been a substantial increase in the incidence of pediatric stress injuries. The differential diagnosis of a stress injury in a child or adolescent can be challenging because the injury sometimes can appear aggressive at imaging assessment...
March 2012: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Anthony J F Robertson, Gregory B Firth, Candice Truda, Dustin A Ramdass, Michelle Groome, Shabir Madhi
BACKGROUND: There is limited information on osteoarticular infections in human immunodeficiency virus (HIV)-infected children. The purpose of this study was to determine the effect of HIV on the epidemiology of osteoarticular infections in a setting with a high prevalence of pediatric HIV infection. METHODS: A retrospective evaluation of children presenting with acute septic arthritis or osteomyelitis from June 2005 to July 2009 was undertaken. Standard departmental protocols for the management of osteoarticular infections, including testing for HIV, were practised...
March 2012: Journal of Pediatric Orthopedics
Shahindokht Bassiri-Jahromi, Aida Doostkam
OBJECTIVE: Chronic granulomatous disease (CGD) is an inherited disorder of the Nicotinamide adenine dinucleotide phosphate reduced oxidase complex characterized by recurrent bacterial and fungal infections. Disseminated infection by combination of opportunistic agents is being increasingly reported in CGD patients. We presented in the retrospective review of medical records, the etiology, presentation, clinical characteristics the infections detected, predisposing condition and outcome of nocardiosis and actinomycosis involved in a group of pediatric patients diagnosed with CGD...
October 2011: Journal of Global Infectious Diseases
Mohan V Belthur, Sherri B Birchansky, Alejandro A Verdugo, Edward O Mason, Kristina G Hulten, Sheldon L Kaplan, E O'Brian Smith, William A Phillips, Jacob Weinberg
BACKGROUND: Osteomyelitis is a common pediatric musculoskeletal infection. This infection can weaken the normal bone structure, resulting in the risk of a pathologic fracture. The purpose of this study was to evaluate the risk factors for pathologic fracture in children with Staphylococcus aureus osteomyelitis. METHODS: Seventeen children who were treated for a pathologic long-bone fracture secondary to Staphylococcus aureus osteomyelitis between January 2001 and January 2009 at a tertiary-care pediatric hospital were identified...
January 4, 2012: Journal of Bone and Joint Surgery. American Volume
Lorna P Browne, R Paul Guillerman, Robert C Orth, Jigar Patel, Edward O Mason, Sheldon L Kaplan
OBJECTIVE: Previous studies have reported that contrast-enhanced sequences do not increase the sensitivity of MRI for the diagnosis of pediatric osteomyelitis and are not needed in the absence of edema on unenhanced MRI sequences. Invasive skeletal infections due to community-acquired Staphylococcus aureus are increasingly encountered in infants and young children and have a proclivity for involvement of both the unossified growth cartilage and the metadiaphyseal bone marrow of the extremities...
January 2012: AJR. American Journal of Roentgenology
Ming-Chun Chen, Shang-Hsien Yang, Ting-Kuo Yao, Pau-Nyen Chong, Shu-Huey Chen
Pyomyositis is a pyogenic muscular tissue infection mainly occurring in immunocompromised patients. Chronic myeloid leukemia (CML) accounts for only 2-3% of cases of childhood leukemia. Herein, we report on a 17-year-old male with bilateral hip pain caused by adductor pyomyositis before beginning the treatment course of CML. CML was diagnosed by bone marrow chromosome study and was treated initially with imatinib but switched to hydroxyurea 5 days later because of poor cytoreduction response. Subsequently, white blood cell counts decreased gradually; however, the hyperleukocytosis condition resolved very slowly again until we switched back to imatinib use on the 40(th) day of hospitalization...
December 2011: Pediatrics and Neonatology
Mehmet Uluğ, Celal Ayaz, Mustafa Kemal Celen
Osteomyelitis in adolescents is a serious disease with the potential for lifelong disability. The key to successful management is early diagnosis, including bone sampling for microbiological and pathological examination to allow targeted and long-lasting antibiotic therapy. Staphylococcus aureus is the most frequently isolated microorganism in these patients. Methicillin-resistant S. aureus (MRSA) is usually considered a nosocomial pathogen, but increasingly it is acquired in the community. We present a case of acute osteomyelitis caused by community-associated MRSA (CA-MRSA) who had never been hospitalized and had no other known risk factors for MRSA...
December 2011: Journal of Infection in Developing Countries
Abdullatif Alenazi, Abdullah Al Sonbul, Suliman Al Jumaah, Ali Al Mehaidib, Sulaiman M Al-Mayouf
BACKGROUND AND OBJECTIVE: Published data from Saudi Arabia regarding autoinflammatory diseases are scarce. In this study, we describe the clinical and laboratory features of autoinflammatory diseases in Saudi children. DESIGN AND SETTING: Restrospective, hospital-based study conducted from January 2010 until June 2010. PATIENTS AND METHODS: Patients with autoinflammatory disease treated at the Pediatric Rheumatology Clinic at King Faisal Specialist Hospital and Research Center, Riyadh, over the past 10 years were included...
January 2012: Annals of Saudi Medicine
Sharat Agarwal, Mohammad Nasim Akhtar, Jerryson Bareh
Brodie's abscess of the tarsal cuboid is a rare presentation of a common disease. In the present report, we describe the case of Brodie's abscess of the tarsal cuboid after a thorn prick in the foot of a 10-year-old boy. The patient was asymptomatic in the acute phase of the injury, and on presentation, no evidence was found of an open cutaneous wound. The foot radiographs showed a cavitary osteolytic lesion in the cuboid bone. Magnetic resonance imaging revealed a classic penumbra sign and an abscess in the plantar intrinsic musculature...
March 2012: Journal of Foot and Ankle Surgery
Meg A Frizzola, James H Hertzog
We report a case of Lemierre syndrome secondary to Streptococcus pyogenes in a 22-month-old girl. This case report and literature review took place at a pediatric intensive care unit at a freestanding tertiary children's hospital. Diagnosis occurred after the discovery of left internal jugular thrombus and multiple metastatic infection sites including the right knee, kidneys, lungs, and brain. Lemierre syndrome can occur in young children secondary to S. pyogenes, and a classic presentation may not occur. A high index of suspicion is crucial to the diagnosis...
November 2011: Pediatric Emergency Care
Pisit Sukswai, Dool Kovitvanitcha, Veerasak Thumkunanon, Tawee Chotpitayasunondh, Varaporn Sangtawesin, Yongyot Jeerathanyasakun
OBJECTIVE: To evaluate the clinical features, causative pathogens and outcomes-related to acute hematogenous osteomyelitis and septic arthritis in pediatric patients. MATERIAL AND METHOD: The authors conducted a retrospective cohort study of patients under 15 years of age with diagnosis of acute hematogenous osteomyelitis (AHO) and/or septic arthritis (SA), treated at Queen Sirikit National Institute of Child Health from 1996 to 2006. Demographic data, clinical characteristics, bacterial spectrum, and outcomes were collected...
August 2011: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Matthew Hansen, Garth Meckler, David Spiro, Craig Newgard
OBJECTIVES: Intraosseous line (IO) use has been described in prehospital settings, with some studies in the emergency department (ED). However, population-based studies describing IO line use across diverse ED and hospital settings are sparse, and the true incidence of complications remains unknown. METHODS: This was a retrospective cohort study using administrative data from 450 California hospitals and EDs. We included all children aged 0 to 18 years with ED or inpatient visits from 2005 through 2007...
October 2011: Pediatric Emergency Care
Allison F Messina, Katie Namtu, Michelle Guild, Juan A Dumois, David M Berman
BACKGROUND: The emergence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has complicated the conventional management of osteomyelitis. While oral clindamycin is commonly used to treat acute CA-MRSA osteomyelitis, the emergence of inducible clindamycin resistance among CA-MRSA isolates has made alternative therapy necessary. The excellent oral bioavailability, susceptibility profile, favorable palatability, and low cost of trimethoprim-sulfamethoxazole (TMP-SMX) make this drug an attractive option for treating osteomyelitis, yet its clinical efficacy for osteomyelitis has not been established...
December 2011: Pediatric Infectious Disease Journal
Isaac Thomsen, C Buddy Creech
Acute hematogenous osteomyelitis is a common disease that affects previously healthy children of all age groups. Despite its importance, there are limited data in the current literature to guide many aspects of the diagnosis and therapy of this infection. Over the last decade, our understanding of the etiology of this infection has changed, with increased recognition of Kingella kingae and the dramatic increase in community-associated Methicillin-resistant Staphylococcus aureus (CA-MRSA) infections. There is a need for the optimization of diagnostic strategies, such as MRI and serum inflammatory markers...
October 2011: Current Infectious Disease Reports
Jonathan E Reitzenstein, Loren G Yamamoto, Hareesh Mavoori
The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are employed in the evaluation of patients with suspected septic arthritis, osteomyelitis, and acute rheumatic fever. The purpose of this study is to determine if one test has greater sensitivity (rises earlier) than the other. Laboratory data were retrieved for pediatric patients hospitalized with one of the above three conditions, who had both ESR and CRP tests done on or shortly prior to admission. Sensitivity calculations were performed for mild, moderate, and severe degrees of ESR and CRP elevation...
2010: Pediatric Reports
Tod A Mattis, Heather L Borders, Doug M Ellinger, Joseph J Junewick
BACKGROUND: MRI is frequently utilized to evaluate patients for osteomyelitis. The findings of intramedullary and extramedullary fat globules as well as extramedullary fat-fluid levels can help improve the specificity of MRI for this diagnosis. OBJECTIVE: To correlate these MRI findings with the clinical characteristics in children with osteomyelitis. MATERIALS AND METHODS: A retrospective electronic medical record search for pediatric patient charts from March 2004 to November 2009 that contained the word "osteomyelitis" in the "principal diagnosis" portion of the international classification of disease (ICD) billing code...
October 2011: Pediatric Radiology
Pavel Koranda, Jarmila Drymlová, Tomáš Malý, Lumír Kantor, Jaroslav Ptáček, Miroslav Mysliveček
Two cases of successful detection of inflammatory foci using Tc-99m exametazime (HMPAO)-labeled leukocyte scintigraphy in premature infants were reported. Necrotizing enterocolitis was detected in a child with a body weight of 1.6 kg. Scintigraphy confirmed a neonatal osteomyelitis in the distal part of the leg of another patient weighing 2.2 kg. These 2 cases indicate that it is feasible to perform Tc-99m HMPAO-labeled leukocyte scintigraphy even if the blood sample volume is lower than the minimal volumes required by the guidelines for pediatric patients...
June 2011: Clinical Nuclear Medicine
J Schedel, B Bach, J B Kümmerle-Deschner, I Kötter
Hereditary periodic (fever) syndromes, also called autoinflammatory syndromes, are characterized by relapsing fever and additional manifestations such as skin rashes, mucosal manifestations, or joint symptoms. Some of these disorders present with organ involvement and serological signs of inflammation without fever. There is a strong serological inflammatory response with an elevation of serum amyloid A (SAA), resulting in an increased risk of secondary amyloidosis. There are monogenic disorders (familial mediterranean fever (FMF), hyper-IgD-syndrome (HIDS), cryopyrin-associated periodic syndromes (CAPS), "pyogenic arthritis, acne, pyoderma gangrenosum" (PAPA), and "pediatric granulomatous arthritis (PGA) where mutations in genes have been described, which in part by influencing the function of the inflammasome, in part by other means, lead to the induction of the production of IL-1β...
May 2011: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
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