Authors:
Martin AC, Anderson D, Lucey J, Guttinger R, Jacoby PA, Mok TJ, et al.
Authors notes:
Pediatric Infectious Disease Journal. 2016;35(4):387-91.
Keywords:
Pediatric Osteomyelitis, acute haematogenous osteomyelitis, children
Abstract:
BACKGROUND: Acute haematogenous osteomyelitis is a bacterial infection of bone, which occurs most frequently in children.
Outcomes are excellent for the majority of children, but a minority develop complicated osteomyelitis.
Predicting which children will develop complicated osteomyelitis remains a challenge, particularly in developed countries where most patients are discharged home after a relatively short period in hospital.
METHODS: We conducted a 5-year retrospective case note review of all children aged 3 months to 16 years admitted with a diagnosis of acute haematogenous osteomyelitis.
We compared standardized clinical and laboratory parameters in those who developed simple and complicated osteomyelitis.
RESULTS: Of the 299 children who met inclusion, 241 (80.6%) had simple and 58 (19.4%) had complicated osteomyelitis.
The major predictors of complicated disease were older age, a temperature greater than 38.5 degrees C and a higher C-reactive protein at admission.
CONCLUSIONS: A risk prediction model, utilizing information available shortly after hospitalization, allows early identification of children at greatest risk of developing complicated osteomyelitis.