Simon C, Wiedemann J, Havemann D
Monatsschr Kinderheilkd (1902). 1975 Nov;123(11):740-4.
In the years 1955-1972 132 children with osteomyelitis were treated in the Pediatric, Surgical and Orthopedic Department of the university of Kiel. There was no increase in the incidence of osteomyelitis during this period. Acute hematogenous osteomyelitis was diagnosed in 111 children, chronic hematogenous osteomyelitis in 11 children, traumatic and postoperative osteomyelitis in 10 children. Secondary chronic osteomyelitis occurred in 1 patient. Mainly staphylococci (in 90%) were the pathogenic bacteria, whereas haemophilus, pseudomonas, streptococci group A, E. coli and mixed infections occurred less frequently. In 17 of 111 patients with acute hematogenous osteomyelitis there were no roentgenological changes. Bacteriological investigations of blood and pus, and the antistaphylolysin reaction (repeated in the course of the disease) were helpful to establish the diagnosis in many cases. 107 of 111 patients with acute hematogenous osteomyelitis were cured (8 patients with defects). 4 children died in septic shock or because of complications (meningitis, pleural empyema, pneumonia). Bactericidal antibiotics in high dosage (penicillins, gentamicin) were superior to bacteriostatic antibiotics. Additional surgical treatment was necessary in 49 of 111 patients with acute hematogenous osteomyelitis. Recommendations for antibiotic therapy of osteomyelitis are given.
1955年至1972年间，基尔大学儿科、外科和骨科共治疗了132例骨髓炎患儿。在此期间，骨髓炎的发病率没有增加。111例患儿被诊断为急性血源性骨髓炎，11例为慢性血源性骨髓炎，10例为创伤性和术后骨髓炎。1例患者发生继发性慢性骨髓炎。主要致病菌为葡萄球菌（90%），而嗜血杆菌、假单胞菌、A组链球菌、大肠杆菌及混合感染较少见。111例急性血源性骨髓炎患者中有17例无X线改变。血液和脓液的细菌学检查以及抗葡萄球菌溶血素反应（在病程中重复进行）在许多病例中有助于确诊。111例急性血源性骨髓炎患者中有107例治愈（8例有后遗症）。4例患儿死于感染性休克或因并发症（脑膜炎、脓胸、肺炎）死亡。高剂量杀菌性抗生素（青霉素、庆大霉素）优于抑菌性抗生素。111例急性血源性骨髓炎患者中有49例需要额外的手术治疗。文中给出了骨髓炎抗生素治疗的建议。
