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KMID : 0367420050480070731
Journal of Korean Pediatric Society
2005 Volume.48 No. 7 p.731 ~ p.736
Clinical Study of Acute Pyogenic Osteomyelitis in Children
Park Ji-Sook

Yeom Jung-Sook
Hwang Sun-Chul
Park Eun-Sil
Seo Ji-Hyun
Lim Jae-Young
Park Chan-Hoo
Woo Hyang-Ok
Youn Hee-Sang
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.
KEYWORD
Osteomyelitis, Signs and symptoms, Treatment
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