Rebecca L Floyed1, Russell W Steele. 1. Division of Infectious Diseases, Department of Pediatrics, LSU Health Sciences Center, Louisiana State University, New Orleans, LA, USA.
Abstract
OBJECTIVE: To examine the natural history, clinical manifestations, laboratory changes and outcomes of children with culture-negative osteomyelitis and to compare findings with cases of culture-positive infection treated during the same time period. DESIGN: Retrospective review of consecutive admissions for osteomyelitis during the 4-year period 1998 through 2001, with a minimum follow-up of 1 year. SETTING: A single urban children's hospital with a large orthopedic referral service. CLINICAL AND LABORATORY MEASURES: Age, gender, predisposing factors, clinical manifestations, maximum temperature, duration of pain, bone involved, laboratory changes, results of cultures from infected bone and blood and outcome after treatment. RESULTS: A total of 85 patients fulfilled study criteria, of whom 40 were culture-negative. Compared with culture-positive cases, culture-negative osteomyelitis patients were less likely to have antecedent trauma (P = 0.0357) and overlying skin changes (P = 0.0001), duration of pain and other symptoms was longer (P = 0.0396) and skeletal residua were rare. They were also older, with this difference approaching statistical significance (P = 0.0586). CONCLUSIONS: Children with culture-negative osteomyelitis present initially differently from culture-positive cases and can be managed as presumed staphylococcal disease with excellent long term results.
OBJECTIVE: To examine the natural history, clinical manifestations, laboratory changes and outcomes of children with culture-negative osteomyelitis and to compare findings with cases of culture-positive infection treated during the same time period. DESIGN: Retrospective review of consecutive admissions for osteomyelitis during the 4-year period 1998 through 2001, with a minimum follow-up of 1 year. SETTING: A single urban children's hospital with a large orthopedic referral service. CLINICAL AND LABORATORY MEASURES: Age, gender, predisposing factors, clinical manifestations, maximum temperature, duration of pain, bone involved, laboratory changes, results of cultures from infected bone and blood and outcome after treatment. RESULTS: A total of 85 patients fulfilled study criteria, of whom 40 were culture-negative. Compared with culture-positive cases, culture-negative osteomyelitispatients were less likely to have antecedent trauma (P = 0.0357) and overlying skin changes (P = 0.0001), duration of pain and other symptoms was longer (P = 0.0396) and skeletal residua were rare. They were also older, with this difference approaching statistical significance (P = 0.0586). CONCLUSIONS:Children with culture-negative osteomyelitis present initially differently from culture-positive cases and can be managed as presumed staphylococcal disease with excellent long term results.
Authors: N Luisa Hiller; Aakash Chauhan; Michael Palmer; Sameer Jain; Nicholas G Sotereanos; Gregory T Altman; Laura Nistico; Rachael Kreft; J Christopher Post; Patrick J Demeo Journal: Springerplus Date: 2015-08-28
Authors: Petteri Lankinen; Marko Seppänen; Kimmo Mattila; Markku Kallajoki; Juhani Knuuti; Hannu T Aro Journal: Contrast Media Mol Imaging Date: 2017-10-11 Impact factor: 3.161