Publication
Acute Haematogenous Osteomyelitis in Lisbon: An Unexpectedly High Association with Myositis and Arthritis
| dc.contributor.author | Gouveia, C | |
| dc.contributor.author | Branco, J | |
| dc.contributor.author | Norte, S | |
| dc.contributor.author | Arcangelo, J | |
| dc.contributor.author | Alves, P | |
| dc.contributor.author | Pinto, M | |
| dc.contributor.author | Tavares, D | |
| dc.date.accessioned | 2022-11-17T14:51:13Z | |
| dc.date.available | 2022-11-17T14:51:13Z | |
| dc.date.issued | 2022 | |
| dc.description.abstract | Introduction: Despite the current trend toward less aggressive therapeutic approaches, acute haematogenous osteomyelitis (AHO) continues to be a challenge and is associated with significant morbidity worldwide. Our aim was to assess whether compliance with the current protocol was achieved in 80% of cases, to identify complications and the associated risk factors, and to analyse trends in the aetiology and management of AHO in the paediatric population. Methods: We conducted a longitudinal, observational, single-centre study in patients with AHO aged less than 18 years admitted to a paediatric hospital between 2008 and 2018 divided in 2 cohorts (before and after 2014). We analysed data concerning demographic and clinical characteristics and outcomes. Results: The study included 71 children with AHO, 56% male, with a median age of 3 years (interquartile range, 1-11). We found a 1.8-fold increase of cases in the last 5 years. The causative agent was identified in 37% of cases: MSSA (54%), MRSA (4%), S. pyogenes (19%), K. kingae (12%), S. pneumoniae (8%), and N. meningitidis (4%). Complications were identified in 45% of patients and sequelae in 3.6%. In recent years, there was an increase in myositis (30% vs 7%; P=.02), septic arthritis (68 vs 37.2%; p=0.012) and in the proportion of patients treated for less than 4 weeks (37 vs 3.5%; p=0.012), with a similar sequelae rates. The risk factors associated with complications were age 3 or more years, C-reactive protein levels of 20mg/L or higher, time elapsed between onset and admission of 5 or more days and positive culture, although the only factor that continued to be significantly associated in the multivariate analysis was positive culture. The presence of complications was a risk factor for sequelae at 6 months. Conclusions: Our study confirms that AHO can be aggressive. The identification of risk factors for complications is essential for management. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | An Pediatr (Engl Ed) . 2022 Feb;96(2):106-114. | pt_PT |
| dc.identifier.doi | 10.1016/j.anpede.2020.11.003 | pt_PT |
| dc.identifier.uri | http://hdl.handle.net/10400.17/4285 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.subject | K. kingae | pt_PT |
| dc.subject | Myositis | pt_PT |
| dc.subject | Osteomyelitis | pt_PT |
| dc.subject | Child | pt_PT |
| dc.subject | HDE INF PED | pt_PT |
| dc.subject | HDE ORT PED | pt_PT |
| dc.subject | HDE IMA | pt_PT |
| dc.subject | HDE PAT CLI | pt_PT |
| dc.title | Acute Haematogenous Osteomyelitis in Lisbon: An Unexpectedly High Association with Myositis and Arthritis | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 114 | pt_PT |
| oaire.citation.issue | 2 | pt_PT |
| oaire.citation.startPage | 106 | pt_PT |
| oaire.citation.title | Anales de Pediatría (English Edition) | pt_PT |
| oaire.citation.volume | 96 | pt_PT |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |