This article presents sonographic diagnosis of acute hematogenous osteomyelitis in early stage.24 clildren with clinically suspected acute hematogtnous osteomyelits were detected to have subptrosteal abscesses by ultr...This article presents sonographic diagnosis of acute hematogenous osteomyelitis in early stage.24 clildren with clinically suspected acute hematogtnous osteomyelits were detected to have subptrosteal abscesses by ultrasond during four to fourteen days after onset.The mean length and anteroposterior distance of the subperiosteal abscesses were 86.4 mm and 10.7 mm,respectively.Of 24 cases of subperiosteal atscesses,aspiration performed under ultrasound guidance revealed purulent fluid in al and 23 were verified surgically.The results obtained indicate that ultrasound can be used it diagnosis of actue hematogerous osteomyelitis in the early stage.the earliest case was diagrosed by ultrasound 4 days afttr onset.By use of ultrasound, differentiation diagnosis of acute hematogenous osteomyelitis from other diseases such as cellulitis,soff tissue abscess,acutt septic arthritis and maignant bone tumors is also discussed.展开更多
Background Acute osteomyelitis still represents a significant clinical challenge,with an increasing incidence in paediatric population.A careful assessment and a rapid diagnosis with proper timing and choice of empiri...Background Acute osteomyelitis still represents a significant clinical challenge,with an increasing incidence in paediatric population.A careful assessment and a rapid diagnosis with proper timing and choice of empirical antimicrobial therapy are necessary to avoid sequelae.The initial treatment should consist of empirical antibiotic therapy,to cover the major responsible pathogens in each age group.Data sources We made a literature search with PubMed and Cochrane database from 2000 to 2019 in English,French,and Spanish languages using the key words"osteomyelitis,children,clinical,diagnosis,and treatment".Results The child's clinical features,age,and the microbiological profile of the geographic area should be evaluated for diagnosis and in the choice of antibiotic treatment.Latest data suggest the administration of intravenous antibiotics for a short period,with subsequent oral therapy,according to the improvement of clinical status and inflammatory markers.For children older than 3 months,the shift to oral medications is already possible after a short course of intravenous therapy,until recovery.The timing for the shift from cefazolin to cephalexin or cefuroxime,intravenous clindamycin to oral clindamycin,and intravenous ceftriaxone+oxacillin to oral equivalents will be decided according to the improvement of clinical status and inflammatory markers.We also present the approach to osteomyelitis due to difficult pathogens,such as Methicillin-resistant Staphylococcus aureus(MRSA)and Panton-Valentine leukocidin(PVL)-positive S.aureus infections.Conclusion In this review,we present the current approach to the clinical diagnosis and management of osteomyelitis in childhood,with an update on recent recommendations,as a useful instrument to understand the rationale of antibiotic therapy.展开更多
文摘This article presents sonographic diagnosis of acute hematogenous osteomyelitis in early stage.24 clildren with clinically suspected acute hematogtnous osteomyelits were detected to have subptrosteal abscesses by ultrasond during four to fourteen days after onset.The mean length and anteroposterior distance of the subperiosteal abscesses were 86.4 mm and 10.7 mm,respectively.Of 24 cases of subperiosteal atscesses,aspiration performed under ultrasound guidance revealed purulent fluid in al and 23 were verified surgically.The results obtained indicate that ultrasound can be used it diagnosis of actue hematogerous osteomyelitis in the early stage.the earliest case was diagrosed by ultrasound 4 days afttr onset.By use of ultrasound, differentiation diagnosis of acute hematogenous osteomyelitis from other diseases such as cellulitis,soff tissue abscess,acutt septic arthritis and maignant bone tumors is also discussed.
文摘Background Acute osteomyelitis still represents a significant clinical challenge,with an increasing incidence in paediatric population.A careful assessment and a rapid diagnosis with proper timing and choice of empirical antimicrobial therapy are necessary to avoid sequelae.The initial treatment should consist of empirical antibiotic therapy,to cover the major responsible pathogens in each age group.Data sources We made a literature search with PubMed and Cochrane database from 2000 to 2019 in English,French,and Spanish languages using the key words"osteomyelitis,children,clinical,diagnosis,and treatment".Results The child's clinical features,age,and the microbiological profile of the geographic area should be evaluated for diagnosis and in the choice of antibiotic treatment.Latest data suggest the administration of intravenous antibiotics for a short period,with subsequent oral therapy,according to the improvement of clinical status and inflammatory markers.For children older than 3 months,the shift to oral medications is already possible after a short course of intravenous therapy,until recovery.The timing for the shift from cefazolin to cephalexin or cefuroxime,intravenous clindamycin to oral clindamycin,and intravenous ceftriaxone+oxacillin to oral equivalents will be decided according to the improvement of clinical status and inflammatory markers.We also present the approach to osteomyelitis due to difficult pathogens,such as Methicillin-resistant Staphylococcus aureus(MRSA)and Panton-Valentine leukocidin(PVL)-positive S.aureus infections.Conclusion In this review,we present the current approach to the clinical diagnosis and management of osteomyelitis in childhood,with an update on recent recommendations,as a useful instrument to understand the rationale of antibiotic therapy.
