Aidan: Created page with "== Background == === Microbiology === * Staphylococcus aureus * Streptococci * Kingella kingae, especially for discitis === Pathophysiology === * Etiology is m..."

2020-08-17T00:11:09Z

Created page with "== Background == === Microbiology === * Staphylococcus aureus * Streptococci * Kingella kingae, especially for discitis === Pathophysiology === * Etiology is m..."

New page

== Background ==

=== Microbiology ===

* [[Staphylococcus aureus]]
* [[Streptococci]]
* [[Kingella kingae]], especially for discitis

=== Pathophysiology ===

* Etiology is mostly due to hematogenous spread
* Bones have increased vascular supply until about 7 years of age

== Investigations ==

* X-ray
** For long bones, X-ray can show changes quickly
*** 3 days after onset of symptoms: soft tissue swelling at the metaphysis
*** 3-7 days: obliteration of the translucent fat planes by edema
*** 10-21 days: bone destruction, osteopenia, cortical thickening, periosteal reactions
** For membranous or irregular bones, bony destruction and periosteal elevation are seen 2 to 3 weeks later than long bones
** For pelvic and vertebral bones, x-ray is unlikely to be helpful
* MRI
** Usually reserved for cases where x-ray is unlikely to be helpful, or where x-ray was negative but clinical suspicion remains

== Management ==

* Start with intravenous therapy targetting [[Staphylococcus aureus]], such as [[cefazolin]]
* Step down to oral therapy such as [[cephalexin]] once:
** Afebrile for 48 hours
** Decreased pain, swelling, and erythema
** WBC normalized
** C-reactive protein consistently decreasing
* Total duration is 4 weeks for typical hematogenous osteomyelitis

[[Category:Infectious diseases]]
[[Category:Pediatrics]]
[[Category:Bone and joint infections]]

Osteomyelitis in children - Revision history

Aidan: Created page with "== Background == === Microbiology === * Staphylococcus aureus * Streptococci * Kingella kingae, especially for discitis === Pathophysiology === * Etiology is m..."