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Clinical Profile of Osteomyelitis and Septic Arthritis in Children in India

Ira Shah 1 Sareena Ameen 1 Rujuta Mehta 2
1Pediatrics and Pediatric Infectious Diseases, B J Wadia Hospital for Children
2Pediatric Orthopedics, B J Wadia Hospital for Children

Aim: To describe the clinical profile of children with pyogenic osteomyelitis(OM) and septic arthritis (SA).

Methods: This observational study was conducted from May 2014 to May 2016. All children diagnosed as pyogenic OM and/or SA were included in the study. Clinical features, immunodeficiency status, the organism isolated and their resistance patterns were evaluated. Factors associated at different age groups was analysed.

Results: Out of 70 children, 18 (25.7%) had tuberculous OM and were excluded from the study. The mean age of presentation was 3.5+4.2 years. 9 (17%) were neonates, 11 (21%) were between 1 month-1 year, 19 (37%) were between 1 to 5 years and 13 (25%) children were >5 years of age. Male:female ratio was 36:16. 39 (75%) patients had lower limb involvement, 8 (15%) patients had upper limb involvement, 4 (7%) had multifocal involvement and only one patient had spinal involvement. Bacterial culture was positive in 39 (75%) patients and MSSA grew in 21 (54%) patients, MRSA grew in 11 (28%), gram negative organisms grew in 4 (10%) and candida species were isolated in 3 (8%) patients. No patient was detected to have acquired or congenital immunodeficiency. 20 (38%) patients had OM of which 19 (95%) were >1 year of age(p=0.0007), 22 (42%) had SA of which 16 (72.7%) were

Conclusion: Staphylococcal aureus is the most common organism isolated with predominant affection in boys. Lower limbs are more commonly affected than upper limbs. OM is more common in children above 1 year of age whereas SA is more common in infants.

Ira Shah
Ira Shah
B J Wadia Hospital for Children








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