Clinical manifestations and outcomes of children with bone and joint infections

Year 2023, Volume: 48 Issue: 4, 1217 - 1227, 29.12.2023

Melis Deniz , Tuğba Erat , Ali Yavuz , Kazım Tasar

https://doi.org/10.17826/cumj.1348227

Cited By: 1

Abstract

Purpose: This study aimed to determine the clinical, laboratory, imaging, and bacteriological features of bone and joint infections in children and to identify their characteristic features for early diagnosis.
Materials and Methods: In this retrospective study patients diagnosed with osteomyelitis and septic arthritis, based on established guidelines, were included. We collected demographic, clinical, and imaging data, along with inflammatory markers and microbiological data, and any invasive procedures performed by orthopedic surgeons. We also reviewed the development of long-term sequelae, the duration of treatments, and the types of antibiotics used for both oral and parenteral therapy.
Results: The study group consisted of 25 patients with osteomyelitis, 10 with septic arthritis, and 5 with combined infection (osteomyelitis and septic arthritis). Inflammatory marker levels were abnormal in most children. The most commonly identified organism was the Staphylococcal species. Radiological findings compatible with bone and joint infections were detected in all patients whose magnetic resonance imaging results were available. Invasive procedures were performed in 44%, 90%, and 100% of the patients with osteomyelitis, septic arthritis, and combined infection, respectively.
Conclusion: Sensitivity increased when all the markers were used together. Magnetic resonance imaging considered the most informative imaging modality for bone and joint infections provided the highest sensitivity in our study. These sensitive indicators can be helpful for the early diagnosis and long-term follow-up of patients with unclear presentations.

Keywords

osteomyelitis, septic arthritis, children

Kemik ve eklem enfeksiyonları olan çocukların klinik bulguları ve sonuçları

Abstract

Amaç: Bu çalışmada çocuklarda kemik ve eklem enfeksiyonlarının klinik, laboratuvar, görüntüleme ve bakteriyolojik özelliklerinin saptanması ve erken tanı için karakteristik özelliklerinin belirlenmesi amaçlandı.
Gereç ve Yöntem: Retrospektif bu çalışmaya pediatrik osteomiyelit ve septik artritin tanı ve tedavisine ilişkin kılavuz kriterlerine göre osteomiyelit ve septik artrit tanısı alan hastalar çalışmaya dahil edildi. Hastaların demografik, klinik ve görüntüleme verilerinin yanı sıra inflamatuar belirteç düzeyleri ve mikrobiyolojik verileri, ortopedi uzmanlarının gerçekleştirdiği invaziv işlemler değerlendirilmiştir. Ayrıca uzun vadeli sekellerin gelişimi, oral ve parenteral tedavide kullanılan antibiyotik türleri ve tedavi sürelerini incelendi.
Bulgular: Çalışma grubunu 25 osteomiyelit, 10 septik artrit ve 5 kombine enfeksiyon (osteomiyelit ve septik artrit) hastası oluşturdu. Çoğu çocukta inflamatuar belirteçler anormal düzeylerdeydi. En sık tanımlanan organizma Stafilokok türleriydi. Manyetik rezonans görüntüleme sonuçları mevcut olan hastaların tamamında kemik ve eklem enfeksiyonları ile uyumlu radyolojik bulgular tespit edildi. Osteomiyelit, septik artrit ve kombine enfeksiyonu olan hastaların sırasıyla %44, %90 ve %100'üne invaziv işlemler uygulanmıştı.
Sonuç: Tüm belirteçlerin bir arada kullanılmasıyla tanıya yönelik sensitivitenin arttığı tespit edildi. Kemik ve eklem enfeksiyonlarında en bilgilendirici görüntüleme yöntemi olarak kabul edilen manyetik rezonans görüntüleme, çalışmamızda en yüksek duyarlılığı sağlamıştır. Bu hassas göstergeler, nonspesifik bulguları olan hastaların erken tanısında ve uzun süreli takibinde yardımcı olabilir.

Keywords

Çocuk, osteomiyelit, septik artrit

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