Journal of the Korean Pediatric Society 2000;43(4):506-513.
Published online April 15, 2000.
Etiologic Agents and Clinical Features of Acute Pyogenic Osteoarthritis in Children
Young Ho Kwak1, Su Eun Park1, Jung Youn Hong1, He Sun Jung1, Jin Young Park2, Jung Hwan Choi1, Hoan Jong Lee1, In Ho Choi3
1Departments of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
2Department of Pediatrics, College of Medicine, Sungkyunkwan University, Seoul, Korea
3Departments of Orthopedics, College of Medicine, Seoul National University, Seoul, Korea
소아기 급성 화농성 골관절염의 원인균 및 임상상
곽영호1, 박수은1, 홍정연1, 정혜선1, 박진영2, 최중환1, 이환종1, 최인호3
1서울대학교 의과대학 소아과학교실
2성균관대학교 의과대학 강북삼성병원 소아과
3서울대학교 의과대학 정형외과학교실
Abstract
Purpose
: Though acute pyogenic infections of musculoskeletal system are infrequent in children, delayed diagnosis or inadequate management may cause serious chronic sequelae. We analysed 40 cases of children who were affected by acute septic osteomyelitis and/or septic arthritis to find etiologic agents and to establish proper initial antimicrobial therapy.
Methods
: Medical records of 40 cases of microbiologically confirmed acute pyogenic osteomyelitis and/or septic arthritis diagnosed at the Seoul National University Children's Hospital from January 1985 to September 1998 were reviewed.
Results
: There were 12 cases of acute osteomyelitis, 28 of acute septic arthritis, and 4 of concurrent cases of two diseases. Of 12 cases of acute pyogenic osteomyelitis, there were 7 boys and 5 girls whose average age was 75.4 months. Calcaneus was infected in 4 cases and it was the most common site. Ten cases(83.3%) of them were attributable to Staphylococcus aureus, 1 to Streptococcus viridans and 1 to Pseudomonas aeruginosa. Among the 28 cases of acute septic arthritis, male to female ratio was 16 : 12. The hip joint was the most frequent site involved in 13 cases(46.3%), followed by the ankle joint, which was involved in 6 cases(21.4%). The majority of the children were infected by S. aureus(20 cases, 71.4%). Two cases were infected by S. viridans or Salmonella(group D) species, and 1 by Haemophilus influenzae.
Conclusion
: S. aureus was the most common pathogen of acute pyogenic osteoarthritis, and H. influenzae was an infrequent cause of septic arthritis. Regarding initial empirical anibiotic therapy, anti-staphylococcal agent should be included.
Key Words: Osteomyelitis, Arthritis, Etiology


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