Original article 102
Acute Multilocular Osteomyelitis in Infancy and Childhood G. Sichardt, S. Hofmann-v. Kap-herr
Summary 38 cases of acute multilocular osteomyelitis out of a total of 165 osteomyelitis patients were treated between 1974 and 1986 at the Department of Paediatric Surgery and Paediatric Diseases at the University of Mainz. Osteomyelitis in infants was separated from juvenile osteomyelitis because of the different problems inherent to this disease depending upon the age; likewise, multilocular remote involvement was separated from regional multiple involvement. It was found that distant involvement is of special importance in infaney. 6 of the 8 eases in this group presented with symmetrical involvement. This interesting phenomenon is described in this article for the first time in acute multilocular osteomyelitis; so far, it was known to oecur only in chronic recurrent multifocal osteomyelitis (CRMO). The infants in this group were predominantly newborn who were particularly severely handicapped by predisposing factors such as necessary intensive-care measures or surgieal interventions. Our findings showed that in this age group most of the problems oecurred, namely: 3 deaths and 2 healing defeets in 8 children. For this reason it is imperative to effect particularly close monitoring of multilocular acute osteomyelitis in infancy. This must be considered as a paediatrie and paediatric-surgical emergeney requiring not onJy aecurate diagnostic measures but also early internistic and surgical treatment to improve the prognosis of this specific disease pattern. Key words
Osteomyelitis
Resume Dans le Service de Chirurgie Infantile de l'Universite de Mayence, on a soigne 165 cas d'osteomyelite dont 38 avec des loealisations multiloculaires aigues entre 1974 et 1986. Les osteomyelites du nourrisson doivent etre
Received June 17, 1990 Eur J Pediatr Surg 1 (1991) 102-109 © Hippokrates Verlag Stuttgart . Masson Editeur Paris
distinguees des autres cas a cause de leur problematique tout a fait differente, en particulier les localisations multiloculaires. De ce fait, il apparatt que Je pronostic est de particuliere importance chez Je nourrisson. Ce groupe comprenait 8 cas sur lesquels 6 ont presente une atteinte symetrique. Ce phenomene interessant est decrit pour la premiere fois dans cet article dans l'osteomyelite multiloculaire aigue. 11 n'etait jusqu'ici connu que dans l'osteomyelite recidivante multiloculaire. Les nourrissons de ce groupe etaient en particulier des nouveaux-nes qui etaient atteints de facteurs predisposant comme en particulier des traitements medicaux intensifs ou des gestes chirurgicaux. C'est dans ces cas et dans ce groupe d'age qu'on a recontre les problemes les plus importants: 3 evolutions mortelles et 2 guerisons incompJetes chez 8 enfants. De cette base, on conclut que J'osteomyelite aigue multiloculaire chez Je nourrisson demande une surveillance toute partieuliere et doit etre consideree comme une urgence pediatrico-chirurgicale ce qui comporte non seulement retablissement rapide du diagnostic exact mais aussi un traitement actif precoee medical et chirurgical de fa. dc Silllghl111 aJlers ,lcon1\' liti uncl (htl'lth lfn I\mdcsall r In:orU'r 1/, Riller G (! !J861 11 ~l I 17 IH 1\//1": R Klinik d r nkulcn ham:lloll",ncn (hll'()Ill\chll' O'I'''IllH,lIllS und (hll'lll, im I\lnd~s;lIlI'r In , ClIIl'I" 11, I?III.,,, C, ( I!lHl\) 2:- :11 ltl "U'lll' I? l'l aL I IC nl(holu!ll~chc und '1.1Il1111I;lphl'ill1l' I)lallm»llk d"l h:illl
Acute Multilocular Osteomyelitis in Infancy and Childhood G. Sichardt, S. Hofmann-v. Kap-herr
Summary 38 cases of acute multilocular osteomyelitis out of a total of 165 osteomyelitis patients were treated between 1974 and 1986 at the Department of Paediatric Surgery and Paediatric Diseases at the University of Mainz. Osteomyelitis in infants was separated from juvenile osteomyelitis because of the different problems inherent to this disease depending upon the age; likewise, multilocular remote involvement was separated from regional multiple involvement. It was found that distant involvement is of special importance in infaney. 6 of the 8 eases in this group presented with symmetrical involvement. This interesting phenomenon is described in this article for the first time in acute multilocular osteomyelitis; so far, it was known to oecur only in chronic recurrent multifocal osteomyelitis (CRMO). The infants in this group were predominantly newborn who were particularly severely handicapped by predisposing factors such as necessary intensive-care measures or surgieal interventions. Our findings showed that in this age group most of the problems oecurred, namely: 3 deaths and 2 healing defeets in 8 children. For this reason it is imperative to effect particularly close monitoring of multilocular acute osteomyelitis in infancy. This must be considered as a paediatrie and paediatric-surgical emergeney requiring not onJy aecurate diagnostic measures but also early internistic and surgical treatment to improve the prognosis of this specific disease pattern. Key words
Osteomyelitis
Resume Dans le Service de Chirurgie Infantile de l'Universite de Mayence, on a soigne 165 cas d'osteomyelite dont 38 avec des loealisations multiloculaires aigues entre 1974 et 1986. Les osteomyelites du nourrisson doivent etre
Received June 17, 1990 Eur J Pediatr Surg 1 (1991) 102-109 © Hippokrates Verlag Stuttgart . Masson Editeur Paris
distinguees des autres cas a cause de leur problematique tout a fait differente, en particulier les localisations multiloculaires. De ce fait, il apparatt que Je pronostic est de particuliere importance chez Je nourrisson. Ce groupe comprenait 8 cas sur lesquels 6 ont presente une atteinte symetrique. Ce phenomene interessant est decrit pour la premiere fois dans cet article dans l'osteomyelite multiloculaire aigue. 11 n'etait jusqu'ici connu que dans l'osteomyelite recidivante multiloculaire. Les nourrissons de ce groupe etaient en particulier des nouveaux-nes qui etaient atteints de facteurs predisposant comme en particulier des traitements medicaux intensifs ou des gestes chirurgicaux. C'est dans ces cas et dans ce groupe d'age qu'on a recontre les problemes les plus importants: 3 evolutions mortelles et 2 guerisons incompJetes chez 8 enfants. De cette base, on conclut que J'osteomyelite aigue multiloculaire chez Je nourrisson demande une surveillance toute partieuliere et doit etre consideree comme une urgence pediatrico-chirurgicale ce qui comporte non seulement retablissement rapide du diagnostic exact mais aussi un traitement actif precoee medical et chirurgical de fa. dc Silllghl111 aJlers ,lcon1\' liti uncl (htl'lth lfn I\mdcsall r In:orU'r 1/, Riller G (! !J861 11 ~l I 17 IH 1\//1": R Klinik d r nkulcn ham:lloll",ncn (hll'()Ill\chll' O'I'''IllH,lIllS und (hll'lll, im I\lnd~s;lIlI'r In , ClIIl'I" 11, I?III.,,, C, ( I!lHl\) 2:- :11 ltl "U'lll' I? l'l aL I IC nl(holu!ll~chc und '1.1Il1111I;lphl'ill1l' I)lallm»llk d"l h:illl
