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Clinical Observation on Osteomyelitis in Children and Infants

Journal of the Korean Pediatric Society 1968;11(3):121-128.
Published online March 31, 1968.
Clinical Observation on Osteomyelitis in Children and Infants
Kew Taek Kim
Department of Pediatrics College of Med. Pusan National University
小兒化膜性骨髓炎에 對한 臨床的 觀察 (116例)
金 窒 宅
釜山大學校 醫科大學 小兒科學敎室
Abstract
The author made a clinical observation on 116 children of osteomyelitis who were treated at Save the Children Fund, Pusan Children’s Charity Hospital and Pediatric Dept, of PNUH from April to August 1966. The results obtained were as follows; 1)The peak incidence occurred in the children of 5 to 13 years and it was 64.7% of total occurrences. 2)Sexual difference was not remarkable, showing slight increase in the male group (53.4%). 3)Seasonal incidence was prominent in the order of summer, spring, winter and autumn.4)As predisposing factors, skin infections were seen in 24.1%, other sources of infection in 23% and the trauma in 15.4%. 5)For the predilection sites, femur was most frequently affected showing 41.4% and less frequent in the order of tibia, humerus, mandible and pelvic bone, etc. 6)Clinical manifestations were marked in the acute cases such as local pain, swelling, motor disturbances, fever and chilling, and tenderness but in chronic cases those were obscure except discharge and sinuses. 7)55.3% of total cases showed leucocytosis and 41.6% anemia. 8)Among 16 cases of blood culture 2 were positive and 14, negative results. In pus culture 65 cases were positive out of 70 specimens but no growth in 5 cases. Staphylococcus aureus was found in 72. 3%, staphylococcus epidermis in 16. 9%, streptococcus in 1.5%, gram negative bacillus in 9.2%. 9)75% of staphylococcus aureus was penicillin resistant but most of them were sensitive in broad spectrum antibiotics (60~80 % ). 10)X-ray showed small lytic bony destructive shadow in 43%, moth eaten and soft tissue changes in 25.9%, sequestrum and involuculum in 24% and periosteal reaction with sclerotic change in 7%. 11)As the clinical response to treatment for 23 cases that were thouht to be relatively acute and begun treatment within 2 weeks of onset, 12 were cured by antibiotics and 11 changed to chronic osteomyelitis.


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