Markus Pääkkönen1, Markku J T Kallio2, Pentti E Kallio3, Heikki Peltola2. 1. Department of Orthopedic Surgery, Turku University Hospital and University of Turku; Departments of Children's Hospital, Helsinki University Central Hospital, Finland. 2. Pediatrics and Children's Hospital, Helsinki University Central Hospital, Finland. 3. Pediatric Surgery, University of Helsinki Children's Hospital, Helsinki University Central Hospital, Finland.
Abstract
BACKGROUND: Synovial fluid and blood cultures often remain negative in acute bone and joint infections of childhood even when characteristic symptoms, signs, and/or radiologic proof are present. METHODS: We analyzed 345 prospectively documented osteoarticular infections in children at age 3 months to 15 years. In 23% of the cases (N = 80), synovial, bone, and/or blood cultures remained negative. The characteristics of these cases were compared with patients with culture-positive bone and joint infections. RESULTS: The 2 groups did not differ in age or gender distribution, surgical procedures performed, or outcome. In the culture-negative cases, the initial serum C-reactive protein level was lower (58 vs 87 mg/L, P < .0001) and the hospital stay was shorter (8 vs 11 days, P < .0001). CONCLUSIONS: Bone and joint infections in which cultures fail to identify the causative agent can be treated similarly as culture-positive cases.
BACKGROUND: Synovial fluid and blood cultures often remain negative in acute bone and joint infections of childhood even when characteristic symptoms, signs, and/or radiologic proof are present. METHODS: We analyzed 345 prospectively documented osteoarticular infections in children at age 3 months to 15 years. In 23% of the cases (N = 80), synovial, bone, and/or blood cultures remained negative. The characteristics of these cases were compared with patients with culture-positive bone and joint infections. RESULTS: The 2 groups did not differ in age or gender distribution, surgical procedures performed, or outcome. In the culture-negative cases, the initial serum C-reactive protein level was lower (58 vs 87 mg/L, P < .0001) and the hospital stay was shorter (8 vs 11 days, P < .0001). CONCLUSIONS: Bone and joint infections in which cultures fail to identify the causative agent can be treated similarly as culture-positive cases.
Authors: Nanda Ramchandar; Jessica Burns; Nicole G Coufal; Andrew Pennock; Benjamin Briggs; Rita Stinnett; John Bradley; John Arnold; George Y Liu; Maya Pring; Vidyadhar V Upasani; Kathleen Rickert; David Dimmock; Charles Chiu; Lauge Farnaes; Christopher Cannavino Journal: Open Forum Infect Dis Date: 2021-07-17 Impact factor: 3.835