Bone Health

Clinical Quiz 11 Year Old With Right Sided Back Pain from Applied Radiology Online Posted 07/27/2004 Jonathan Gordon, M.D., Ph.D. Summary 11 year old with right sided back and lower extremity pain.

Osteomyelitis in children in Nigeria: is surgical decompression necessary? African Journal of Biomedical Research 7(3)2004

Editorial Paediatrics and Child Health May/June 2001, Volume 6, Number 5 Flesh-eating disease: A note on necrotizing fasciitis H Dele Davies MD MSc, Child Health Research Unit, Alberta Children’s Hospital and Departments of Pediatrics, Microbiology and Infectious Diseases and Community Health Sciences, University of Calgary, Calgary, Alberta There has been much media attention in the past few years to the condition dubbed ‘flesh-eating disease’, which refers, primarily, to a form of invasive group A beta hemolytic streptococcal (GABHS) infection that leads to fascia and muscle necrosis. In 1999, the Canadian Paediatric Society issued a statement on the state of knowledge and management of children, and close contacts of persons with all-invasive GABHS disease (1). The present note is intended to deal specifically with necrotizing fasciitis (NF) by providing an update on the limited current state of knowledge, diagnosis and management. Surveillance to establish actual national rates and epidemiology of NF through the Canadian Paediatric Society is proposed.

MEDLINE Abstracts: Osteomyelitis in Children from Medscape Orthopaedics & Sports Medicine What's new in osteomyelitis in children? Find out in this easy-to-navigate collection of recent MEDLINE abstracts pulled together by the editors at Medscape Orthopaedics and Sports Medicine 1997

From Morbidity & Mortality Weekly Report Osteomyelitis/Septic Arthritis Caused by Kingella kingae Among Day Care Attendees - Minnesota, 2003 Posted 04/05/2004 Content Kingella kingae is a fastidious gram-negative coccobacillus that colonizes the respiratory and oropharyngeal tract in children. K. kingae occasionally causes invasive disease, primarily osteomyelitis/septic arthritis in young children, bacteremia in infants, and endocarditis in school-aged children and adults.[1-8] Although diagnosis of this organism frequently is missed, invasive disease is uncommon. Only sporadic, non-epidemiologically linked cases have been reported previously. In October 2003, the Minnesota Department of Health (MDH) investigated a cluster of two confirmed cases and one probable case of osteomyelitis/septic arthritis caused by K. kingae among children aged 17-21 months attending the same toddler classroom in a day care center. All reported within the same week with onset of fever, preceding or concurrent upper respiratory illness (URI), and refusal to bear weight on the affected limb. This report summarizes these cases and describes the epidemiologic investigation of the day care center. The findings underscore the need for clinicians and laboratorians to consider K. kingae infection in young children with Gram stain-negative or culture-negative skeletal infection

Paediatric bone and joint infection N Susan Stott Starship Children's Hospital, Auckland, New Zealand Paediatric musculoskeletal infection remains an important cause of morbidity. Methicillin sensitive Staphylococcus aureus is still the most common organism although the incidence of methicillin resistant S. aureus in the community is rising. Osteomyelitis and septic arthritis due to Haemophilus influenzae is decreasing in incidence secondary to immunisation and in some units has been replaced by infections with the gram negative bacillus, Kingella kingae. Recent prospective studies indicate that uncomplicated osteomyelitis can be treated by three to four weeks of antibiotics. However, there is still a small group of children who will have overwhelming disseminated infection. These children require aggressive surgical and medical intervention. Two recent reports have identified an increased incidence of septic arthritis in children who have hemophilia and are HIV positive. Journal of Orthopaedic Surgery 2001, 9(1):83–90

SUBACUTE EPIPHYSEAL OSTEOMYELITIS

Radiology case 48--214 HIV patient

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