title: Atypical mycobacterial granulomatous epiphyseal osteomyelitis in an immunocompetent child.
abstract: Osteomyelitis caused by atypical mycobacteria is rare in children. The majority of affected patients have had some kind of predisposing factor, namely a penetrating injury or surgery, or were immune-compromised. Our experience shows that this diagnosis should be considered in apparently healthy children as well. The use of polymerase chain reaction has now made it possible to identify the pathogen in cases that were previously diagnosed as granulomatous osteomyelitis. We present a case of atypical mycobacterial osteomyelitis affecting the distal femoral epiphysis in an immunocompetent 10-year-old child. The diagnosis in this case was made by the use of the polymerase chain reaction assay.
authors.affiliation: Department of Pediatric Orthopaedics, Dana Children's Hospital, Tel Aviv Medical Center, Israel. shayek@tasmc.health.gov.il
authors.forename: Shlomo
authors.initials: S
authors.lastname: Hayek
authors.forename: Josephine
authors.initials: J
authors.lastname: Issakov
authors.forename: Eli
authors.initials: E
authors.lastname: Ezra
authors.forename: Shlomo
authors.initials: S
authors.lastname: Wientroub
authors.forename: Moshe
authors.initials: M
authors.lastname: Yaniv
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D004269:DNA, Bacterial / Q000032:analysis; D003646:Debridement / Q000379:methods; D004838:Epiphyses / Q000382:microbiology / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000382:microbiology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000628:therapy*; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification*; D010019:Osteomyelitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy*; D010147:Pain Measurement; D016133:Polymerase Chain Reaction; D020127:Recovery of Function; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000995:Antitubercular Agents; D004269:DNA, Bacterial