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儿童锁骨骨髓炎1例罕见病例及文献复习

A Rare Case of Clavicle Osteomyelitis in a Child and Literature Review.

作者信息

Chrysochoou Elisavet-Anna, Antachopoulos Charalampos, Badekas Konstantinos, Roilides Emmanuel

机构信息

Infectious Diseases Unit, 3rd Department of Pediatrics, Medical Faculty, Aristotle University School of Health Sciences, Hippokration Hospital, Thessaloniki, Greece.

Department of Pediatrics, General Hospital of Serres, Serres, Central Macedonia, Greece.

出版信息

Case Rep Pediatr. 2016;2016:8252318. doi: 10.1155/2016/8252318. Epub 2016 Dec 5.

Abstract

Acute clavicle osteomyelitis in children is rare representing <3% of osteomyelitis cases. We treated a 12-year-old boy who presented with acute pain in the right clavicle and high fever for 4 days. MRI showed abnormal signal in the right clavicle with periosteal reaction. isolated from blood was susceptible to methicillin, clindamycin, and macrolides. Clindamycin was given intravenously for 3 wks and orally for another 3 wks with no recurrence. We reviewed clavicle osteomyelitis cases in children searching PubMed English literature. From a total of 89 studies retrieved, only 6 fulfilled the criteria and were analyzed. Sixteen patients (56% female) were included with a median age of 9 yrs (range 2 wks-16 yrs). Osteomyelitis was hematogenous in most cases, with being the most frequent cause, isolated from either blood or tissue. Symptoms included fever, swelling, and localized bone tenderness. Antimicrobial therapy lasted for 4-12 weeks (median 7.5). Three patients required drainage or curettage. Recurrence occurred in 1/16 cases (6.2%) and persistence of symptoms occurred to 2/16 cases (12.5%) reported before 90s with unknown antimicrobial susceptibility of the pathogen. Acute clavicle osteomyelitis mainly affects older children and has generally good prognosis. is most commonly implicated and surgery may be needed.

摘要

儿童急性锁骨骨髓炎较为罕见,占骨髓炎病例的比例不到3%。我们治疗了一名12岁男孩,他右锁骨急性疼痛并高热4天。MRI显示右锁骨信号异常并伴有骨膜反应。从血液中分离出的病原体对甲氧西林、克林霉素和大环内酯类药物敏感。静脉注射克林霉素3周,随后口服3周,无复发。我们检索了PubMed英文文献中的儿童锁骨骨髓炎病例。在检索到的89项研究中,只有6项符合标准并进行了分析。纳入了16例患者(56%为女性),中位年龄为9岁(范围为2周 - 16岁)。大多数情况下骨髓炎是血源性的, 是最常见的病因,从血液或组织中分离得到。症状包括发热、肿胀和局部骨压痛。抗菌治疗持续4 - 12周(中位7.5周)。3例患者需要引流或刮除术。1/16例(6.2%)出现复发,2/16例(12.5%)出现症状持续,这些是90年代之前报道的病例,病原体的抗菌药敏情况未知。急性锁骨骨髓炎主要影响大龄儿童,总体预后良好。 最常涉及,可能需要手术治疗。 (注:原文中部分处有缺失信息,用“ ”表示)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9646/5165129/86b9588e17c7/CRIPE2016-8252318.001.jpg

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