Deep venous thrombosis associated with acute hematogenous osteomyelitis in children.
BACKGROUND
Deep venous thrombosis (DVT) is rare in children. It may complicate acute hematogenous osteomyelitis (AHO).


OBJECTIVE
The present study assessed the incidence of DVT in community-acquired AHO, and compared clinical and laboratory characteristics with AHO without DVT.


METHODS
A prospective study included patients treated for community-acquired AHO between April 2007 and December 2009.


RESULTS
Seventy patients were included: mean age, 7.7 years. Seven developed DVT. All involved Staphylococcus aureus. The isolated Staphylococcus aureus was significantly more often methicillin-resistant than methicillin-susceptible (p=0.04). C-reactive protein, erythrocyte sedimentation rate, positive blood culture and incidence of pulmonary staphylococcus were significantly higher in patients with DVT. These patients also had significantly more febrile days. One patient with DVT died from severe refractory respiratory failure.


CONCLUSIONS
DVT was observed in 10% of cases of community-acquired AHO. DVT was associated with more severe onset, with extensive local disease. Surgery was often needed to drain a subperiosteal abscess. DVT can cause invasive and life-threatening infection through septic emboli, particularly to the lungs.


METHODS
Level III.
Bouchoucha
S
S
Pediatric Orthopaedics Department, Tunis Children's Hospital, place Bab Saadoun, 1007 Tunis Jabbari, Tunisia. sami.bouchoucha@yahoo.com
Benghachame
F
F
Trifa
M
M
Saied
W
W
Douira
W
W
Nessib
M N
MN
Ghachem
M B
MB
D000038:Abscess / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D003430:Cross-Sectional Studies; D003952:Diagnostic Imaging; D004322:Drainage; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D010019:Osteomyelitis / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D011446:Prospective Studies; D018805:Sepsis / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery