title: Septicemia in a child undergoing callotasis limb lengthening.
abstract: We report a patient undergoing femoral callotasis lengthening using the dynamic axial fixator to correct a post-infective leg length discrepancy of 7.8 cm. Seventeen days after the operation, the patient developed a pin site infection, which was successfully treated by oral antibiotics. On the 34th post-operative day, the infection reoccurred, and was accompanied by generalized malaise, vomiting and pyrexia. Serology identified Staphylococcus aureus enterotoxin. Following removal of the fixator, the child recovered, but only four cm of lengthening was achieved. The pins probably acted as a persistent foreign body, with local inflammation creating favorable ground for bacterial infection. The role of the previous multifocal osteomyelitis unclear, but it could have acted as a continuous source of pathogens. The resulting toxemia was not immediately suspected, and could have resulted in the loss of the patient had the fixator not been removed promptly.
authors.affiliation: Department of Radiology, Hospital for Sick Children, London, England.
authors.forename: I
authors.initials: I
authors.lastname: Minty
authors.forename: N
authors.initials: N
authors.lastname: Maffulli
authors.forename: J A
authors.initials: JA
authors.lastname: Fixsen
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000209:etiology* / Q000628:therapy; D001852:Bone Lengthening / Q000009:adverse effects / Q000295:instrumentation; D002648:Child; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects; D007870:Leg Length Inequality / Q000601:surgery; D008297:Male; D012086:Reoperation; D013203:Staphylococcal Infections / Q000209:etiology* / Q000628:therapy; D013530:Surgical Wound Infection / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents