Venous thrombosis and thromboembolism in children with osteomyelitis.
OBJECTIVE
To determine the prevalence and clinical features of deep vein thrombosis (DVT) complicating osteomyelitis during childhood.


METHODS
We retrospectively reviewed medical records of all patients with osteomyelitis admitted to Children's Medical Center Dallas between July 1, 2003 and December 31, 2004. Analysis was performed on patients with proximal upper or lower extremity, pelvic or vertebral osteomyelitis (a subgroup considered to be at highest risk for infection-related thrombosis).


RESULTS
Thirty-five patients had confirmed osteomyelitis of the proximal humerus, proximal tibia/fibula, femur, pelvis, or vertebrae. Ten of these 35 children (29%) developed DVT during the acute infection based on imaging studies performed. Eight thrombi occurred adjacent to the infection and two occurred in relation to central venous catheters. Six of the 10 children with DVT also had evidence of infection disseminated to lung, brain, or heart, compared with only 1 of 25 patients without DVT (P = .001). Hospitalization was longer in those with DVT than without (33.5 v. 14.2 days, P = .001).


CONCLUSIONS
Thromboembolic complications can occur in the setting of osteomyelitis, and affected patients may be at higher risk of disseminated infection.
Crary
Shelley E
SE
University of Texas Southwestern Medical Center at Dallas, Division of Pediatric Hematology-Oncology, Dallas, Texas 75390, USA. shelley.crary@utsouthwestern.edu
Buchanan
George R
GR
Drake
Casey E
CE
Journeycake
Janna M
JM
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000150:complications* / Q000382:microbiology; D012189:Retrospective Studies; D013923:Thromboembolism / Q000209:etiology*; D020246:Venous Thrombosis / Q000209:etiology*