All issues > Volume 48(7); 2005

Original Article

Korean J Pediatr. 2005;48(7):731-736. Published online July 15, 2005.

Clinical Study of Acute Pyogenic Osteomyelitis in Children

Ji Sook JS Park¹, Jeong Suk JS Yeom¹, Sun Chul SC Hwang², Eun Sil ES Park¹, Ji Hyun JH Seo¹, Jae Young JY Lim¹, Chan Hoo CH Park¹, Hyang Ok HO Woo¹, Hee Shang HS Youn¹

¹Department of Pediatrics, College of Medicine, Gyeongsang National University, Jinju, Korea
²Department of Orthopedics, College of Medicine, Gyeongsang National University, Jinju, Korea

Correspondence Ji Hyun JH Seo ,Email: seozee@gshp.gsnu.ac.kr

Abstract

Purpose
: Acute pyogenic osteomyelitis is uncommon in children. Delayed diagnosis and inappropriate treatment are leading to growth failure and deformation. We review the clinical manifestations and treatment of acute osteomyelitis in children according to age.
Methods
: A retrospective analysis was made of 32 patients who underwent antibiotic management or operation between Aug 1989 and Dec 2003 for acute pyogenic osteomyelitis in age from 0 to 15 years old.
Results
: The study group was composed of 21 boys and 11 girls. The subjects were divided into four groups according to age : 0-1 yr(n=6), 1-5 yr(n=11), 6-10 yr(n=8), and 11-15 yr(n=7). Nineteen cases were diagnosed in Winter. Femur was the most common infected site(37.5%). There were no predisposing factor in 17 patients, and 7 of 15 patients had trauma history. Sepsis was important predisposing factor in neonates. The chief complaints were pain, swelling and fever. S. aureus(61%) is the most common organism. Twenty-nine patients were treated with operation and concomitant antibiotics. Two cases had sequelae in follow-up period : One is avascular necrosis of femur and the other is discrepancy of leg length.
Conclusion
: In our review, because of poor prognosis in septic neonates, we recommend to treat actively neonatal sepsis and prevent or detect osteomyelitis early. Because most of patients were diagnosed and treated in orthopedic surgery, the rate of operation was too high. So, protocol for further evaluation and management of acute osteomyelitis in pediatric patients were needed.

Keywords :Osteomyelitis , Signs and symptoms , Treatment