Clinical report and predictors of sequelae of 319 cases of pediatric bacterial osteomyelitis
Andrzej Krzysztofiak, Marco Roversi, Antonio Musolino, Marco Cirillo, Renato Maria Toniolo, Osvaldo Mazza, Livia Gargiullo, Laura Lancella, Paolo Rossi, Alberto Villani, Collaborative Osteomyelitis Study Group, Domenico Barbuti, Stefania Bernardi, Paola Bernaschi, Francesco Biagiarelli, Elena Boccuzzi, Elena Bozzola, Francesca Ippolita Calò Carducci, Sara Chiurchiù, Marco Crostelli, Laura Cursi, Maia De Luca, Martina Di Giuseppe, Fabrizio De Benedetti, Daniele Deriu, Marco Giordano, Annalisa Grandin, Antonella Insalaco, Elena Inzaghi, Andrzej Krzysztofiak, Alessandra Marchesi, Maria Rosaria Marchili, Gianluca Mirra, Antonio Musolino, Gian Luigi Natali, Valeria Pansini, Massimo Fabio Pezzoli, Lorenza Romani, Lelia Rotondi Aufiero, Marco Roversi, Isabella Tarissi De Iacobis, Anna Chiara Vittucci
Abstract
Pediatric osteomyelitis is an insidious disease that can lead to permanent sequelae, the management of which still relies on lengthy intravenous antibiotic therapy. The purpose of this study is to report and describe the clinical course and outcome of pediatric bacterial osteomyelitis in our experience. We reported the clinical, diagnostic, and treatment characteristics of all cases of osteomyelitis in children younger than 18 years of age who were hospitalized between January 2010 and December 2021 at the Bambino Gesù Children's Hospital in Rome, Italy, we compared patients with and without complications at follow-up, to identify any predictive factor for sequelae. The study sample included 319 cases of pediatric bacterial osteomyelitis. The median age was 7.77 years. Males (60.8%) were more affected than females. The most affected bones were the femur, tibia, and spine. Etiology was identified in 40.1% of cases, with S.aureus as the most common causative agent. Sequelae were reported in 43 cases (13.5%). The main predictors of sequelae were sepsis on admission and hypergammaglobulinemia. Our results show that a severe presentation with sepsis and hypergammaglobulinemia on admission may be associated with a higher frequency of late sequelae. Early recognition and aggressive treatment of this subgroup of patients may lead to a reduction in complications.