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Acute Hematogenous Osteomyelitis of the Pelvis in Children.

PEDIATRIC INFECTIOUS DISEASE JOURNAL(2024)

Univ Arkansas Med Sci | Baylor Coll Med

Cited 0|Views16
Abstract
Background: Pelvic involvement has been reported in 3%-14% of acute hematogenous osteomyelitis (AHO) cases in children. One guideline suggests need for a longer antibiotic course in pelvic AHO, however, recent data are lacking. We describe the clinical course of children with pelvic AHO and compare it to nonpelvic AHO. Methods: A retrospective review of patients with a diagnosis of AHO admitted to Texas Children's Hospital from January 2012 to December 2020 was conducted. Patients 6 months-<19 years old and with <= 14 days of symptoms at admission were eligible. Patients with sickle cell disease or immunocompromised were excluded. Wilcoxon rank-sum test assessed for differences between continuous variables and Fisher exact for categorical variables using STATA 17. Results: We compared 104 cases of pelvic AHO to 314 cases of nonpelvic AHO. Patients had similar microbiology, length of stay and length of antibiotic therapy. Patients with pelvic AHO had pyomyositis identified by magnetic resonance imaging more often (28.8 vs. 9.4%, P < 0.001) and bone abscess less often (22.1 vs. 46.5%, P < 0.001). Rates of chronic complications were comparable between patients with pelvic AHO and nonpelvic AHO (8.4% vs. 15.1%, P = 0.1). Nineteen patients (18.3%) with pelvic AHO received <= 30 antibiotic days without complications, but they had less need for intensive care or bone abscesses than patients treated longer. Conclusions: Pelvic AHO in children may be more frequent than previously reported but is not associated with more complications. Four weeks of therapy may be sufficient in selected patients. Prospective studies to compare outcomes with different lengths of therapy are needed.
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pelvis,acute hematogenous osteomyelitis,children
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要点】:本文分析了儿童急性血源性骨髓炎中骨盆受累的情况,发现骨盆受累的病例并不比非骨盆受累的病例有更多的并发症,且部分患者接受4周抗生素治疗已足够。

方法】:通过回顾性分析2012年至2020年德州儿童医院诊断为急性血源性骨髓炎的患者的病例资料,对骨盆受累和非骨盆受累的病例进行了比较。

实验】:研究包含了104例骨盆受累的急性血源性骨髓炎病例和314例非骨盆受累的病例,使用STATA 17软件对连续变量和分类变量进行了统计分析,结果显示骨盆受累的病例在磁共振成像中更常发现脓肿肌炎(28.8% vs. 9.4%),而骨脓肿较少(22.1% vs. 46.5%)。