Hematogenous osteomyelitis in children.
In a 10-year period, 31 children, including 9 infants, were treated for hematogenous osteomyelitis. Fifteen children were treated closed and 16 open. Thirteen of 14 positive cultures were Staphylococcus aureus. Three recurrences could possibly have been prevented by a more aggressive primary approach. At follow-up after 5 (1-12) years, 3 neonates had developed severe growth disturbances despite optimal initial treatment. Acceptable results were obtained with antibiotic therapy for 6 weeks or more. We recommend ampicillin and a penicillinase-resistant penicillin, unless bacterial resistance patterns indicate a different antibiotic. We operate if pus has formed and if a child with severe symptoms does not improve during adequate antibiotic treatment and immobilization.
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001848:Bone Diseases, Developmental / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010019:Osteomyelitis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D011859:Radiography; D012008:Recurrence; D018805:Sepsis / Q000188:drug therapy*; D013203:Staphylococcal Infections / Q000188:drug therapy
D000900:Anti-Bacterial Agents