| Changing pattern of osteomyelitis in infants and children. | |
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MedLine Citation:
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PMID: 10415287 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A retrospective analysis of 332 children with osteomyelitis (OM), managed from 1966 to 1996, was undertaken to evaluate etiology, clinical course and treatment results. In 64% of all patients positive bacterial cultures were obtained, Staphylococcus aureus, streptococci, pneumococci, and Haemophilus influenzae were the most frequently cultured pathogens. In two-thirds of the cases long bones (femur, tibia, humerus) were affected. Osteoarthritis or suppurative arthritis was evident in 27%; 32 of 170 (19%) re-evaluated patients had moderate or severe sequelae. Risk factors for an unfavorable course were the onset of disease in early infancy, suppurative arthritis, and an affected epiphysis. Suppurative arthritis, in particular, needs early evacuation to prevent sequelae. In recent years we observed an increasing number of patients presenting with atypical forms of OM. Since 1989 10 patients were considered to have chronic recurrent multifocal OM (CRMO). In 6 of them the clavicle was involved; their ages ranged from 3 to 14 years. The erythrocyte sedimentation rate was elevated (median 48, range 9-110 mm), while other inflammatory parameters like C-reactive protein (median 9, range <5-85 mg/l) or leucocyte count were slightly elevated or normal. Histopathology was stage-dependent, with a predominance of lymphoplasmacellular infiltration. A nonbacterial origin of CRMO is probable but not proven. Histopathology is not suitable for differentiation between bacterial and nonbacterial forms of bone inflammation. |
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Authors:
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R Tröbs; R Möritz; U Bühligen; J Bennek; W Handrick; D Hörmann; T Meier |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pediatric surgery international Volume: 15 ISSN: 0179-0358 ISO Abbreviation: Pediatr. Surg. Int. Publication Date: 1999 Jul |
Date Detail:
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Created Date: 1999-09-02 Completed Date: 1999-09-02 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8609169 Medline TA: Pediatr Surg Int Country: GERMANY |
Other Details:
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Languages: eng Pagination: 363-72 Citation Subset: IM |
Affiliation:
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Klinik und Poliklinik für Kinderchirurgie, Theresienstrasse 43, D-04129 Leipzig, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adolescent Anti-Bacterial Agents / therapeutic use Blood Sedimentation C-Reactive Protein / metabolism Child Child, Preschool Chronic Disease Combined Modality Therapy Debridement Diagnosis, Differential Female Humans Leukocyte Count Male Osteomyelitis / blood, classification, diagnosis, etiology*, therapy* Recurrence Retrospective Studies Risk Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 9007-41-4/C-Reactive Protein |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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