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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Multifocal osteomyelitis is considered an uncommon complication of acute osteomyelitis. Over a 3-year period, 136 infants and children who had a final diagnosis of acute osteomyelitis were reviewed, and multifocal osteomyelitis was detected in 27 (19%) patients. The major age peak of acute osteomyelitis was between 6 weeks and 3 years (46%). Two age peaks were found for multifocal disease-less than 6 weeks (38%), and 9 to 12 years (44%). Three patients with multifocal disease had septicemia and photon-deficient areas on bone scans. Another adolescent group had nonspecific bone and joint pain that in some cases persisted for more than 3 months and were finally diagnosed as multifocal osteomyelitis. Organisms were isolated in 15/27 (56%). Multifocal osteomyelitis is well recognized in the neonatel age group. However, it occurs more commonly than previously described in older patients. This higher incidence can most likely be attributed to the higher use of the radionuclide bone scan early in the disease and the high sensitivity of the scan for the detection of osteomyelitis.
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PMID:Multifocal osteomyelitis in childhood. Review by radionuclide bone scan. 157 14

Three patients beyond the neonatal period with group B streptococcal infection were presented, including acute osteomyelitis and septic arthritis, bacteremia and septicemia. Serotyping was done in two patients. One was type Ia and the other was type III. All patients recovered from the disease.
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PMID:Group B streptococcal infection in children beyond neonatal period: report of 3 patients. 179 59

The cases of nine children who survived the acute stage of meningococcal septicemia and secondary disseminated intravascular coagulation were reviewed. All of the children had major orthopaedic problems as a result of the acute disease. Detailed histological studies were performed on specimens of bone and cartilage, obtained when these patients had either acute amputation for gangrene or subsequent revision for a chondro-osseous deformity. In the specimens that were obtained from the children who had acute gangrene, the histological changes included small-vessel thrombi, osteonecrosis, subperiosteal new-bone formation, cortical disruption, cellular disorganization in the physis, and medullary inflammation. These findings were compatible with a combination of inflammation (acute osteomyelitis) and ischemia. In the specimens that were obtained during revision of the amputation, three years or more after the initial infectious or ischemic process, the clinically relevant findings involved the epiphyses and physes. The growth plates showed variable permanent ischemic damage. Bone bridges connecting the epiphysis and metaphysis were observed in various stages of formation, including several early bridges with involvement of only the physis and metaphysis. Endosteal and cortical bone, in contrast, showed complete recovery with no evidence of permanent ischemic damage. We concluded that children who survive meningococcal septicemia are at high risk for complex orthopaedic problems, both acute and chronic. The disseminated intravascular coagulation and focal infections of the acute phase are primarily responsible for the vascular injuries to the growing chondro-osseous tissues. Ischemic changes also selectively involve the physeal circulation, but may take several years to adversely affect longitudinal and transverse growth of bone.
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PMID:Chondro-osseous growth abnormalities after meningococcemia. A clinical and histopathological study. 250 9

Two cases are reported of Lemierre's post-anginal septicemia. One was fatal due to extensive septic pneumonia, while the other presented as acute osteomyelitis. Both cases were preceded by oropharyngeal infections.
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PMID:[Anaerobic septicemia following oropharyngeal infections (Lemierre's postanginal septicemia): a forgotten syndrome]. 666 44

Modern imaging techniques have become essential components of the management of acute osteomyelitis and septic arthritis in children. This article addresses the role of these techniques, based on clinical practice guidelines recently developed at a children's hospital by an interdisciplinary group. The recommendations reflect a review of the literature and an analysis of our own experience with 84 children treated for musculoskeletal sepsis during the past 3 years. We attempt to optimize imaging resources by analyzing the unique aspects of these infections in the pediatric skeleton, the clinical needs at different stages of the disease, and the relative strengths and weaknesses of the various imaging procedures. Our goal was to define the use of imaging in cases of osteomyelitis and septic arthritis in children in specific clinical scenarios in which additional information is likely to lead to management modification.
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PMID:Osteomyelitis and septic arthritis in children: appropriate use of imaging to guide treatment. 862 67

Serious staphylococcal infections remain a significant clinical problem despite advances in antibacterial therapy. Resistance to penicillin is common and methicillin-resistant staphylococci have become troublesome nosocomial pathogens in many institutions. Penicillinase-resistant penicillins (e.g. flucloxacillin, cloxacillin and oxacillin) are the preferred drugs for all methicillin-susceptible staphylococcal infections, although first generation cephalosporins, beta-lactam/beta-lactamase inhibitor combinations, clindamycin, and occasionally erythromycin and cotrimoxazole (trimethoprim/sulfamethoxazole) are alternatives. Serious infections due to methicillin-resistant staphylococci should be treated with parenteral vancomycin. Teicoplanin, where available, is a suitable alternative. Rifampicin, fusidic acid and some fluoroquinolones may be useful oral alternatives, although resistance develops rapidly if they are used as single agents. Cotrimoxazole and minocycline have also proven useful when strains are susceptible. Staphylococcal toxic shock syndrome often requires aggressive resuscitation and anti-staphylococcal therapy for generally 10 to 14 days. Staphylococcus aureus bacteraemia remains a life-threatening condition which, in all but one-third of cases, is associated with an underlying septic focus such as endocarditis, osteomyelitis or occult abscess. Differentiating between complicated and uncomplicated bacteraemia is critical to define the appropriate treatment regimen. Serious staphylococcal sepsis such as endocarditis and acute osteomyelitis generally requires prolonged (4 to 6 weeks) antibiotic treatment. Coagulase-negative staphylococci are the commonest cause of prosthetic device infection, and generally require prolonged therapy with an agent to which they have proven to be sensitive, e.g. a penicillinase-resistant penicillin or vancomycin. Removal of infected foreign or prosthetic material, and drainage of deep collections remain a critical aspect of all therapy.
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PMID:Optimum treatment of staphylococcal infections. 768 6

The Authors report two cases of acute osteomyelitis, in a newborn and in an infant. Bone and joint sepsis in the first years of life is rare. The metaphases of long bones are the most common sites of hematogenous osteomyelitis. The hip and the knee are especially at risk. The patients were treated with pharmacologic and orthopedic therapy. The Authors describe the clinical features, radiographic changes, the diagnosis and management of this disease.
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PMID:[Acute osteoarthritis in the newborn and infants]. 819 16

The genus Pasteurella is part of the normal oral flora of many animals, including domestic cats and dogs. In humans, Pasteurella may cause complications ranging from cellulitis to septicemia but rarely causes osteomyelitis or septic arthritis after bites and/or scratches by cats and dogs. Although Pasteurella multocida is a common cause of infection, other Pasteurella species have also been cultured from wounds in humans. We describe here, a case of a cutaneous abscess and acute osteomyelitis associated with P canis after a domestic dog bite. To our knowledge, no previous case of P canis has been reported as the cause of acute osteomyelitis in humans.
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PMID:Pasteurella canis osteomyelitis and cutaneous abscess after a domestic dog bite. 1200 98

Fluids, medications, and blood products can be rapidly administered via intraosseous infusion under emergency conditions, particularly to pediatric patients aged from 0 to 2 years. A five-month-old infant who had been hospitalized with a diagnosis of sepsis developed swelling and hyperemia at the infusion site 10 days after an intraosseous infusion in the right proximal tibia. Physical examination showed a serous discharge from a fistula on the anteromedial side of the right proximal cruris. Plain radiographs demonstrated periosteal reaction in the right tibia and osteolytic areas in the proximal metaphysis. With a diagnosis of acute osteomyelitis, drainage and medullary irrigation were performed and parenteral antibiotic treatment was initiated. Cultures from the surgical site yielded Candida albicans, upon which fluconazole (8 mg/kg) treatment was administered for four weeks. A complete clinical and radiographic improvement was observed at the end of a 12-month follow-up.
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PMID:[Tibial osteomyelitis following intraosseous infusion: a case report]. 1572 19

In the clinical practice of paediatric orthopaedic surgery, there are a few cases of acute osteomyelitis which are not characterized by general and local infectious syndrome, making the diagnosis difficult and leading to severe complications. The specific locations, seldom affected, are the spine, pubis, ilium, ischium, sacrum and coccyx. Comparing with other regions, spinal osteomyelitis is less frequent (1:80). It affects not only children, sometimes aged under one year, but also adults of 40-50 years old. The infection may be located in the vertebral body or vertebral arch. Osteomyelitis of the pubis is diagnosed too late if based only on clinical data. The bone abscess is frequently located in the horizontal branch. During the first three days of evolution, the patient has an acute infectious syndrome and tenderness in pelvic area. Osteomyelitis of the ilium is the most frequent osteomyelitis of the hip bones. The abscess may diffuse anteriorly in the Scarpa triangle or may infiltrate the lesser pelvis. The lack of local signs may lead to serious errors, which may determine severe complications, including death. The infection of the ischium is extremely rare. The local infectious syndrome becomes apparent late and consists of gluteal and perineal swelling. Most frequently, the osteomyelitis of the sacrum is also diagnosed late and clinically appears like septicemia, meningitis or peritonitis. Being situated close to the skin, the osteomyelitis of the coccyx is easily diagnosed, but it appears only exceptionally.
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PMID:Acute osteomyelitis--special cases with particularities related to specific locations. 1876 6


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