RESUMO
We report a unique case of neonatal mycotic internal iliac artery aneurysm managed non-operatively. The child had multifocal osteomyelitis and no history of umbilical artery catheterisation. The aneurysm was regularly scanned and monitored until its obliteration by thrombus 17 days after initial detection. Contingency plans for either interventional radiological coiling or open surgical repair were in place had the aneurysm grown or the child deteriorated.
Assuntos
Aneurisma Infectado/terapia , Aneurisma Ilíaco/terapia , Infecções Estafilocócicas/terapia , Aneurisma Infectado/congênito , Antibacterianos/uso terapêutico , Infecções por Bacillaceae/congênito , Infecções por Bacillaceae/terapia , Bacillus , Terapia Combinada , Humanos , Aneurisma Ilíaco/congênito , Recém-Nascido , Masculino , Osteomielite/congênito , Osteomielite/terapia , Infecções Estafilocócicas/congênitoRESUMO
Acute osteomyelitis of the clavicle accounts for less than 3% of osteomyelitis cases, with its usual location in the middle third. It may be hematogenous, due to contiguity, or secondary to catheterization of the subclavian vein or neck surgery. The diagnosis is often delayed, and clinical symptoms may simulate obstetric brachial plexus palsy in young children. We report a new case of osteomyelitis of the clavicle in a 30-day-old newborn.
Assuntos
Clavícula , Infecções por Haemophilus/diagnóstico , Haemophilus influenzae , Transmissão Vertical de Doenças Infecciosas , Osteomielite/congênito , Osteomielite/diagnóstico , Infecções Estreptocócicas/congênito , Infecções Estreptocócicas/diagnóstico , Abscesso/congênito , Abscesso/diagnóstico , Abscesso/tratamento farmacológico , Administração Oral , Combinação Amoxicilina e Clavulanato de Potássio/administração & dosagem , Antibacterianos/administração & dosagem , Cateterismo Venoso Central , Cefotaxima/administração & dosagem , Clavícula/lesões , Feminino , Febre de Causa Desconhecida/tratamento farmacológico , Febre de Causa Desconhecida/etiologia , Seguimentos , Fosfomicina/administração & dosagem , Fraturas Espontâneas/congênito , Fraturas Espontâneas/diagnóstico , Fraturas Espontâneas/tratamento farmacológico , Infecções por Haemophilus/tratamento farmacológico , Humanos , Lactente , Recém-Nascido , Infusões Intravenosas , Masculino , Osteomielite/tratamento farmacológico , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Cintilografia , Sepse/diagnóstico , Sepse/tratamento farmacológico , Infecções Estreptocócicas/tratamento farmacológico , UltrassonografiaRESUMO
Acute osteomyelitis in neonates, although rare, represents a diagnostic and therapeutic challenge. We herein report an extremely rare case of congenital nonsyphilitic iliac bone osteomyelitis caused by methicilline-sensitive Staphylococcus aureus and presenting with gluteal syndrome in a near-term infant. To our knowledge, this represents the second report with iliac osteomyelitis and the first report with gluteal syndrome in neonatal period. A high index of suspicion is necessary to make an early diagnosis. Early diagnosis is essential to prevent catastrophic sequelae in such cases. We report this case because of its unusual clinical presentation and rarity.
Assuntos
Doenças em Gêmeos/congênito , Doenças em Gêmeos/diagnóstico , Ílio , Osteomielite/congênito , Osteomielite/diagnóstico , Nádegas , Diagnóstico Diferencial , Doenças em Gêmeos/sangue , Doenças em Gêmeos/microbiologia , Humanos , Recém-Nascido , Imageamento por Ressonância Magnética , Masculino , Osteomielite/sangue , Osteomielite/diagnóstico por imagem , Osteomielite/microbiologia , Infecções Estafilocócicas/complicações , Tomografia Computadorizada por Raios XAssuntos
Síndrome de Bandas Amnióticas/complicações , Amputação Traumática , Ruptura Prematura de Membranas Fetais/etiologia , Osteomielite/congênito , Complicações na Gravidez/patologia , Síndrome de Bandas Amnióticas/patologia , Corioamnionite/patologia , Feminino , Feto , Humanos , Recém-Nascido , Oligo-Hidrâmnio/patologia , Osteomielite/etiologia , Osteomielite/patologia , GravidezRESUMO
Acute hematogenous osteomyelitis most frequently occurs in children, generally around 6 to 9 years of age. If it occurs in early infancy, the infection usually involves both the bone and the joint, nearly simultaneously. Neonatal osteomyelitis is another presentation, with an osteomyelitic focus in the metaphysis. We report a case of septic arthritis following osteomyelitis of the hip joint in a neonate caused by a virulent pathogenic organism. Despite late diagnosis and treatment, outcome was very satisfactory with few sequelae for the joint and epiphysis. It should be emphasized that early diagnosis, with prompt and adequate treatment is essential to achieve good outcome. We discuss this case and present a review of the literature.
Assuntos
Artrite Infecciosa/congênito , Cabeça do Fêmur/microbiologia , Doenças do Prematuro/microbiologia , Recém-Nascido Prematuro , Osteoartrite do Quadril/congênito , Osteomielite/congênito , Infecções Estafilocócicas/congênito , Artrite Infecciosa/microbiologia , Feminino , Seguimentos , Humanos , Recém-Nascido , Desigualdade de Membros Inferiores/etiologia , Osteoartrite do Quadril/microbiologia , Osteomielite/microbiologia , Amplitude de Movimento Articular/fisiologiaRESUMO
We report an extremely rare case of congenital nonsyphilitic osteomyelitis in a very preterm infant, providing a unique illustration of the radiological appearances at birth, which may serve as a reference to facilitate diagnosis.
Assuntos
Osteomielite/congênito , Osteomielite/diagnóstico por imagem , Anti-Infecciosos/uso terapêutico , Consanguinidade , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Osteomielite/tratamento farmacológico , Radiografia TorácicaRESUMO
Ulnar clubhand is a rare deformity. In a patient with postnatal osteomyelitis of the ulna, the wrist had an ulnar deviation with marked ulnar slope of the radius. Good hand function precluded surgical correction.
Assuntos
Deformidades Adquiridas da Mão/etiologia , Osteomielite/congênito , Adolescente , Deformidades Adquiridas da Mão/diagnóstico por imagem , Humanos , Masculino , Osteomielite/complicações , Radiografia , Ulna/diagnóstico por imagemRESUMO
The neonate is unable to relate specific complaints of pain and may not exhibit the usual signs of illness or infection. Septic arthritis of the hip is a surgical emergency in the neonate, and it should be considered in any irritable or ill child who has a high index of suspicion. Prompt diagnosis and immediate treatment are necessary. Nearly all babies undergo routine examination of the hip for dysplasia. It is recognized that limitation of abduction of the hip in the neonate may not represent developmental dysplasia of the hip but may represent other etiologies, such as fracture, infection, congenital anomaly, or tumor. The following case report illustrates the importance of careful clinical evaluation of an apparent asymptomatic neonate.
Assuntos
Artrite Infecciosa/congênito , Artrite Infecciosa/diagnóstico , Articulação do Quadril , Ílio , Osteomielite/congênito , Osteomielite/diagnóstico , Infecções Estreptocócicas/diagnóstico , Humanos , Recém-Nascido , Masculino , Infecções Estreptocócicas/congênitoRESUMO
A retrospective study was done to review the clinical experience of septic arthritis and osteomyelitis in the newborns in our centre. Case records of all the neonates born from January 1989 to August 1994 and those admitted to outborn nursery from 1985 to 1993 were reviewed. Diagnosis of septic arthritis/osteomyelitis was made in the presence of relevant clinical signs and supported by positive culture from blood or joint fluid and abnormal X-ray or ultrasound findings. The incidence of septic arthritis and osteomyelitis among inborn babies was 1 in 1500. There were 25 neonates with mean gestational age 34.5 (range 27-40) weeks and mean birth weight 2269 (range 990-4750) gms. Limitation of movement (64%) and local swelling (60%) were commonest presentations. A total of 33 joints were involved in 25 babies. Eight babies (32%) had multiple joint involvement. Hip and knee were the most commonly involved joints (48% each). In 19 babies (76%) joint involvement occurred in association with a generalized septicemic illness while 6 babies (24%) had localised signs and symptoms. Joint aspirate was positive for gram stain or culture in 12 (48%) and 10 babies (40%) had positive blood culture. Klebsiella pneumoniae and Staphylococcus aureus were commonest isolates. Radiological changes were seen in 13 (52%) babies. All were treated with appropriate antibiotics and open surgical drainage was done in 5 (20%) cases. Bone and joint infections are important complications in sick septicemic neonates and need early diagnosis, appropriate management with antibiotics, surgical drainage in selected cases to prevent long term morbidity.
Assuntos
Artrite Infecciosa/congênito , Doenças do Prematuro/diagnóstico , Osteomielite/congênito , Artrite Infecciosa/diagnóstico , Artrite Infecciosa/etiologia , Feminino , Humanos , Índia , Recém-Nascido , Doenças do Prematuro/etiologia , Infecções por Klebsiella/congênito , Infecções por Klebsiella/diagnóstico , Infecções por Klebsiella/etiologia , Klebsiella pneumoniae , Masculino , Osteomielite/diagnóstico , Osteomielite/etiologia , Infecções Estafilocócicas/congênito , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/etiologiaRESUMO
Osteomyelitis has many forms of presentation in the pediatric age group. From neonatal osteomyelitis, with a paucity of clinical symptoms and signs, to the more typical acute hematogenous form or even the subacute or chronic presentations, a high index of suspicion is needed to institute appropriate investigations and treatment.
Assuntos
Neoplasias Ósseas/diagnóstico , Osteomielite/diagnóstico , Criança , Pré-Escolar , Diagnóstico Diferencial , Humanos , Lactente , Recém-Nascido , Osteomielite/congênitoRESUMO
Gram-negative neonatal septicemia was diagnosed in a premature Standardbred colt. Clinical signs included lethargy, weakness, loss of suckle reflex, tachypnea, and injected mucous membranes. Sequelae included pneumonia, omphalophlebitis, septic arthritis, and osteomyelitis. Prepartum maternal uterine infection, premature delivery, abnormal parturition with premature fetal membrane separation, and failure of passive transfer of colostral immunoglobulins increased the foal's risk for developing sepsis. Treatment included administration of moxalactam disodium and cefadroxil. The clinical efficacy of cephalosporin antibiotics in the treatment of gram-negative sepsis is discussed.
Assuntos
Doenças dos Cavalos/congênito , Infecções por Klebsiella/veterinária , Osteomielite/veterinária , Flebite/veterinária , Sepse/veterinária , Animais , Animais Recém-Nascidos , Doenças dos Cavalos/diagnóstico por imagem , Doenças dos Cavalos/microbiologia , Cavalos , Infecções por Klebsiella/complicações , Infecções por Klebsiella/congênito , Masculino , Osteomielite/complicações , Osteomielite/congênito , Osteomielite/diagnóstico por imagem , Osteomielite/microbiologia , Flebite/complicações , Flebite/congênito , Flebite/microbiologia , Radiografia , Sepse/complicações , Sepse/congênitoAssuntos
Osteocondrite/congênito , Osteomielite/congênito , Periostite/congênito , Sífilis Congênita/complicações , Feminino , Humanos , Recém-Nascido , Penicilina G/uso terapêutico , Radiografia , Sorodiagnóstico da Sífilis , Sífilis Congênita/diagnóstico por imagem , Sífilis Congênita/tratamento farmacológicoRESUMO
A case of a newborn with osteomyelitis of the spinous processes 10 and 11 is presented. The first clinical sign was a dorsothoracal abscess. Radiologically a destruction of the 10th, later also the 11th spinous process could be demonstrated. Staphylococcus aureus was isolated. The clinical course was mild. The pathogenesis of the disease is discussed. Such a case of newborn osteomyelitis has apparently not been described in the literature.
Assuntos
Abscesso/congênito , Osteomielite/congênito , Infecções Estafilocócicas/congênito , Vértebras Torácicas , Abscesso/diagnóstico por imagem , Antibacterianos/uso terapêutico , Drenagem , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Osteomielite/diagnóstico por imagem , Radiografia , Infecções Estafilocócicas/diagnóstico por imagem , Vértebras Torácicas/diagnóstico por imagemRESUMO
A newborn baby presented with hyaline membrane disease, interstitial pneumonia, jaundice, hepatosplenomegaly, and unusual bone manifestations with lytic and sclerotic bone lesions and virtually absent periosteal reaction. He subsequently developed intracranial calcifications and mental retardation. The pneumonia and hepatosplenomegaly resolved. At the time of the delivery, a sibling was suffering from a severe undetermined viral infection. The clinical evolution of the disease and the radiologic findings led us to believe that this patient had a prenatal viral infection. The laboratory tests and the histologic picture of the bone biopsy supported the diagnosis.
Assuntos
Osteíte/congênito , Osteomielite/congênito , Humanos , Recém-Nascido , Masculino , Transtornos Mieloproliferativos/patologia , Osteíte/diagnóstico por imagem , Osteomielite/diagnóstico por imagem , Osteomielite/microbiologia , Osteomielite/patologia , RadiografiaRESUMO
A case of third generation early congenital syphilis with unusual features is reported and discussed. The infant presented with Livedo reticularis and an ulcer on the right forearm since birth; the underlying radius and ulna showed osteomyelitic changes with sequestrum formation and a pathological fracture. The rest of the skeletal system was normal. The blood STS (VDRL) was reactive at 1:64. The child showed no other evidence of congenital syphilis. Livedo reticularis and bony lesions resolved promptly with penicillin therapy, but abnormal movements at the wrist joint persisted. The mother had pathognomic Hutchinsonian incisors and a reactive VDRL test.