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Surgical treatment of an infant with Bacille Calmette-Guérin osteomyelitis extending across the growth plate.
MedLine Citation:
PMID:  21210615     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Bacille Calmette-Guérin osteomyelitis in infants is a known complication of Bacille Calmette-Guérin vaccination. Treatment consists of antituberculosis chemotherapy after biopsy/curettage; however, in cases of Bacille Calmette-Guérin osteomyelitis extending to the growth plate and epiphysis, the extent and time of surgical treatment such as curettage/biopsy is unknown because of bone growth disturbances. This article presents a case of an infant with this type of Bacille Calmette-Guérin osteomyelitis at the proximal tibia. A metaanalytic review was performed for possible risk factors of its recurrence. In our patient, primary curettage of partial lesion, excluding the part extending to the growth plate and epiphysis, failed, and recurettage of the extended lesion involving the growth plate and epiphysis was required for its eradication, resulting in bone growth disturbance. In the metaanalysis, 7 literatures reporting 14 cases of Bacille Calmette-Guérin osteomyelitis extending to the growth plate and epiphysis were included. Although statistical analysis showed no significant risk factors associated with the recurrence, these cases showed high recurrence rate in approximately 55.6%, requiring reoperation. Generally, the smaller damage to the growth plate can minimize bone growth disturbance. Taken together, it is suggested that Bacille Calmette-Guérin osteomyelitis extending to the growth plate and epiphysis is associated with high recurrence rate, and early curettage of the entire lesion should be performed to eradicate it and avoid resulting complications.
Authors:
Daichi Ishimaru; Hiroyasu Ogawa; Yoshiki Ito; Katsuji Shimizu
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Publication Detail:
Type:  Journal Article     Date:  2011-01-03
Journal Detail:
Title:  Orthopedics     Volume:  34     ISSN:  1938-2367     ISO Abbreviation:  Orthopedics     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806107     Medline TA:  Orthopedics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  55     Citation Subset:  IM    
Copyright Information:
Copyright 2011, SLACK Incorporated.
Affiliation:
Department of Orthopedic Surgery, Takayama Redcross Hospital, Gifu, Japan.
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