All issues > Volume 43(4); 2000

Original Article

J Korean Pediatr Soc. 2000;43(4):506-513. Published online April 15, 2000.

Etiologic Agents and Clinical Features of Acute Pyogenic Osteoarthritis in Children

Young Ho YH Kwak¹, Su Eun SE Park¹, Jung Youn JY Hong¹, He Sun HS Jung¹, Jin Young JY Park², Jung Hwan JH Choi¹, Hoan Jong HJ Lee¹, In Ho IH 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

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.

Keywords :Osteomyelitis, Arthritis, Etiology