Le Saux Nicole
Canadian Paediatric Society, Infectious Diseases and Immunization Committee, Ottawa, Ontario.
Paediatr Child Health. 2018 Aug;23(5):336-343. doi: 10.1093/pch/pxy049. Epub 2018 Jul 18.
Acute hematogenous osteomyelitis and septic arthritis are not uncommon infections in children and should be considered as part of the differential diagnosis of limb pain and pseudoparalysis. Most bone infections in children arise secondary to hematogenous seeding of bacteria into bone. The most common pathogens are and . Children with septic arthritis should be evaluated promptly by orthopedic specialists for aspiration and possible debridement of concomitant osteomyelitis. Optimal empiric therapy after appropriate cultures continues to be intravenous cefazolin. In most cases, conversion to oral antimicrobials should occur when the patient has clinically improved and has decreasing inflammatory markers. For most uncomplicated cases of osteomyelitis, current recommendations are 3 to 4 weeks of antimicrobial therapy compared with the 6 weeks previously recommended.
急性血源性骨髓炎和化脓性关节炎在儿童中并非罕见感染，应被视为肢体疼痛和假性麻痹鉴别诊断的一部分。儿童的大多数骨感染继发于细菌经血行播散至骨。最常见的病原体是……和……。患有化脓性关节炎的儿童应由骨科专家迅速进行评估，以便对伴发的骨髓炎进行穿刺抽吸和可能的清创。在进行适当培养后，最佳经验性治疗仍然是静脉注射头孢唑林。在大多数情况下，当患者临床症状改善且炎症指标下降时，应转为口服抗菌药物。对于大多数非复杂性骨髓炎病例，目前的建议是进行3至4周的抗菌治疗，而之前建议的是6周。
