Bleckwenn Markus, Sommer Bernd, Weckbecker Klaus
Department of General Practice and Family Medicine, University Medical Center Friedrich-Wilhelm University Bonn, Sigmund-Freud-Str, 25, 53127 Bonn, Germany.
BMC Res Notes. 2014 Nov 5;7:786. doi: 10.1186/1756-0500-7-786.
Chronic recurrent multifocal osteomyelitis is a form of non-bacterial osteomyelitis which occurs primarily in childhood. In some cases painful bone swelling occurs. After a malignancy has been ruled out, antibiotic therapy is often started to treat the osteomyelitis. The course of this benign disease is self-limiting and is not positively affected by the antibiotic therapy.
A 14-year-old German girl from South Africa came to the surgery with painful swelling in the right clavicle. The condition had first appeared two months earlier. The patient was unable to identify a trigger. In addition, the patient exhibited painless swelling in the area of the 5th metatarsal of the left foot. Chronic recurrent multifocal osteomyelitis was diagnosed based on characteristic clinical symptoms and imaging. Treatment with ibuprofen had caused the symptoms to regress rapidly.
The case demonstrates to general practitioners and other clinicians that a prolonged administration of antibiotics can be prevented by means of a comprehensive diagnostic procedure for possible bacterial osteomyelitis.
慢性复发性多灶性骨髓炎是一种主要发生于儿童期的非细菌性骨髓炎。在某些病例中,会出现疼痛性骨肿胀。在排除恶性肿瘤后,通常会开始使用抗生素治疗骨髓炎。这种良性疾病的病程是自限性的,抗生素治疗对其没有积极影响。
一名来自南非的14岁德国女孩因右锁骨疼痛性肿胀前来外科就诊。该病症于两个月前首次出现。患者无法确定诱因。此外,患者左脚第五跖骨区域出现无痛性肿胀。根据特征性临床症状和影像学检查诊断为慢性复发性多灶性骨髓炎。使用布洛芬治疗后症状迅速消退。
该病例向全科医生和其他临床医生表明,通过针对可能的细菌性骨髓炎的综合诊断程序,可以避免长期使用抗生素。