title: Chronic osteomyelitis in children: Shriners Hospital Honolulu experience.
abstract: Chronic osteomyelitis incidence and severity in 55 hospitalized Pacific Island children between 1990 and 2002 were compared with the expected incidence and reports in the literature. Of these 55 cases, 87% were from Polynesia/Micronesia. The average length of hospital stay was 104 days. Staphylococcus aureus was cultured in 64% of the cases with 43% of those being methicillin resistant S. aureus. A total of 111 bones were involved. Average antibiotic treatment was 135 days. Each case required an average of 1.3 irrigations/debridements and 45% required a sequestrectomy. Ninety-two percent had elevated erythrocyte sedimentation rate on admission. Sixty-nine percent of the cases involved metaphyseal, diaphyseal and epiphyseal segments of the bone and 29% were multifocal. Results indicate that Pacific Island children have a higher incidence and increased severity of osteomyelitis when compared with non-Pacific Island children in the literature, requiring a high suspicion for multifocal osteomyelitis, extensive bone involvement, S. aureus positive cultures and a longer period of antibiotic treatment.
authors.affiliation: Shriners Hospital for Children, and John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii 96826-1099, USA.
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Matzkin
authors.forename: Danielle N
authors.initials: DN
authors.lastname: Dabbs
authors.forename: Ramona R
authors.initials: RR
authors.lastname: Fillman
authors.forename: Wade T
authors.initials: WT
authors.lastname: Kyono
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Yandow
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003646:Debridement / Q000706:statistics & numerical data; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D016106:Methicillin Resistance; D044468:Native Hawaiian or Pacific Islander; D010019:Osteomyelitis / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013203:Staphylococcal Infections / Q000453:epidemiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D007507:Therapeutic Irrigation / Q000706:statistics & numerical data
chemical_list: D000900:Anti-Bacterial Agents