title: Early detection of sequela-prone osteomyelitis in children with use of simple clinical and laboratory criteria.
abstract: To determine which clinical or laboratory criteria best reflected the prognosis for 83 children with acute hematogenous osteomyelitis (AHO), they were compared with outcomes after a follow-up of at least 2 months (for 78%, > or = 6 months). Twenty-eight children (34%) developed sequelae. They had higher serum C-reactive protein (CRP) concentrations (days 1-6 of treatment; P = .0004 to .0001) and higher clinical scores (P = .0001) than did patients who had an uneventful recovery. The frequency of sequelae increased from 3% to 73% (P = .0001) when CRP concentrations exceeded the defined cutoff limits and the clinical scores were > or = 1. Age, the duration of symptoms at diagnosis, and the type and duration of intravenous antimicrobial therapy or surgical management did not differ (P > .05) between children with and without sequelae. Both CRP determinations and clinical evaluations with use of a scoring system enable early detection of sequela-prone AHO in children and are most accurate when used together.
authors.affiliation: National Children's Hospital, San José, Costa Rica.
authors.forename: I
authors.initials: I
authors.lastname: Roine
authors.forename: A
authors.initials: A
authors.lastname: Arguedas
authors.forename: I
authors.initials: I
authors.lastname: Faingezicht
authors.forename: F
authors.initials: F
authors.lastname: Rodriguez
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D019411:Clinical Laboratory Techniques / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D010019:Osteomyelitis / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein