Lebel M H, Nelson J D
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas 75235.
Pediatr Infect Dis J. 1988 Apr;7(4):250-4. doi: 10.1097/00006454-198804000-00003.
Haemophilus influenzae type b has rarely been implicated as a pathogen of osteomyelitis in infants and children. Sixteen cases of Haemophilus osteomyelitis were identified in a 28-year review, representing 4.4% of all cases during that period. In the 1 to 24 months age group, H. influenzae type b caused 13.3% of all cases of osteomyelitis. The mean age was 15 months (range, 12 days to 34 months). All cases had fever, 75% had a history of a preceding respiratory tract infection, 75% had localized swelling, 69% had decreased range of motion of the affected or adjacent joint, 38% had local erythema and 13% had localized tenderness. The lower extremities were involved more often than the upper limbs. Concurrent adjacent suppurative arthritis was present in 75% and meningitis in 19% of patients. Clinical resolution was satisfactory in all but two of our patients, and both were associated with suppurative arthritis and inadequate surgical drainage.
b型流感嗜血杆菌很少被认为是婴幼儿骨髓炎的病原体。在一项为期28年的回顾中，共确诊了16例流感嗜血杆菌骨髓炎病例，占该时期所有病例的4.4%。在1至24个月龄组中，b型流感嗜血杆菌导致了13.3%的骨髓炎病例。平均年龄为15个月（范围为12天至34个月）。所有病例均有发热，75%有上呼吸道感染病史，75%有局部肿胀，69%患侧或相邻关节活动范围减小，38%有局部红斑，13%有局部压痛。下肢受累比上肢更常见。75%的患者并发相邻化脓性关节炎，19%并发脑膜炎。除两名患者外，其余患者的临床症状均得到满意缓解，这两名患者均与化脓性关节炎及手术引流不充分有关。
