Karwowska A, Davies H D, Jadavji T
Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Canada.
Pediatr Infect Dis J. 1998 Nov;17(11):1021-6. doi: 10.1097/00006454-199811000-00012.
There has been little recent information on the epidemiology and outcome of childhood osteomyelitis since the era of sequential intravenous-oral antibiotic therapy.
Retrospective chart review.
To review the recent experience and outcome of osteomyelitis in children.
Between 1984 and 1996 we identified 146 patients with osteomyelitis. Decreased limb use and fever were the most common presenting symptoms, and tenderness was the most common sign. Staphylococcus aureus was the most common causative organism, and Haemophilus influenzae was not identified after 1990. Bone biopsies or aspirates were superior (83%) to blood cultures (32%) in yielding organisms. 99mTc bone scan was the most sensitive imaging test (94%). Lack of use of anti-teichoic acid titers and serum bactericidal titers did not adversely affect outcome. The median duration of intravenous antibiotic therapy was 11 days, with a median duration of total antibiotics of 38 days. Complications occurred in 6.6% of patients.
S. aureus remains the most important cause of osteomyelitis. Despite inconsistent use of tests for diagnosis and management and use of sequential intravenous-oral therapy, the overall outcome remains excellent.
自序贯静脉-口服抗生素治疗时代以来，关于儿童骨髓炎的流行病学和转归的近期信息很少。
回顾性病历审查。
回顾儿童骨髓炎的近期经验和转归。
1984年至1996年间，我们确定了146例骨髓炎患者。肢体活动减少和发热是最常见的首发症状，压痛是最常见的体征。金黄色葡萄球菌是最常见的致病微生物，1990年后未发现流感嗜血杆菌。骨活检或骨穿刺培养出病原体的阳性率（83%）高于血培养（32%）。99mTc骨扫描是最敏感的影像学检查（94%）。未使用抗磷壁酸抗体滴度和血清杀菌滴度检测对转归无不利影响。静脉抗生素治疗的中位持续时间为11天，抗生素总中位持续时间为38天。6.6%的患者出现并发症。
金黄色葡萄球菌仍然是骨髓炎最重要的病因。尽管诊断和治疗检测方法使用不一致以及采用序贯静脉-口服治疗，但总体转归仍然良好。
