Publication
Osteomielitis Hematógena Aguda en Lisboa: Asociación con Miositis y Artritis Inesperadamente Alta
| 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 | 2023-03-21T12:54:51Z | |
| dc.date.available | 2023-03-21T12:54:51Z | |
| dc.date.issued | 2022 | |
| dc.description.abstract | Introduction: Despite the current trend towards less aggressive therapeutic approaches, acute haematogenous osteomyelitis (AHO) continues to be a challenge and is associated with significant morbidity worldwide. Our aim was to determine if 80% compliance with current protocol was achieved, identify complications and associated risk factors and analyse trends in aetiology and management of AHO in children. 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 into 2 cohorts (before and after 2014). Demographic, clinical data and disease progression were analysed. 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%), Streptococcus pyogenes (19%), Kingella kingae (12%), Streptococcus pneumoniae (8%), and Neisseria 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=0.02), 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 for complications were age 3 or more years, CRP levels of 20mg/l or higher, time elapsed between onset and admission of 5 or more days and positive culture, although on multivariate analysis only positive culture was significant. 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 may be fundamental for management. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | Anales Pediatría.2022; 96:106-114 | pt_PT |
| dc.identifier.doi | 10.1016/j.anpedi.2020.11.031 | pt_PT |
| dc.identifier.uri | http://hdl.handle.net/10400.17/4467 | |
| dc.language.iso | spa | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Elsevier | pt_PT |
| dc.subject | Osteomielitis | pt_PT |
| dc.subject | Miositis | pt_PT |
| dc.subject | Kingella kingae | pt_PT |
| dc.subject | Child | pt_PT |
| dc.subject | HDE INF PED | pt_PT |
| dc.subject | HDE ORT PED | pt_PT |
| dc.subject | HDE PAT CLIN | pt_PT |
| dc.title | Osteomielitis Hematógena Aguda en Lisboa: Asociación con Miositis y Artritis Inesperadamente Alta | pt_PT |
| dc.title.alternative | 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 | pt_PT |
| oaire.citation.volume | 96 | pt_PT |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |