Abstract:
:Diagnostic tools for the management of acute osteomyelitis (OM) and septic arthritis (SA) have improved over the last decade. To investigate the influence and availability of magnetic resonance imaging (MRI) and nucleic acid testing (NAT), a retrospective cohort study was done. Patients admitted with acute OM or SA between 2005 and 2014 were identified using ICD-10 discharge codes. Ninety-six children were identified: OM, n = 45; SA, n = 42; and OM + SA, n = 9. Diagnostic imaging was performed in 100% of OM or OM + SA and 95% of SA patients. MRI was performed in 85% of OM patients, 26% of SA patients and 100% OM + SA patients. In patients with OM or SA, concomitant joint/bone involvement was detected in 24 and 36% of patients, respectively. In 58% of patients, a pathogen was detected (Staphylococcus aureus, Streptococcus pyogenes and Streptococcus pneumoniae being most common). Blood and tissue culture were positive in 41 and 86% for OM patients and in 14 and 41%, respectively, for SA patients. In 42% of patients, no pathogen was identified, of which 40% had no material for blood or tissue culture/NAT taken. CONCLUSION:Optimal use of imaging modalities including MRI and systematic pathogen detection including NAT should be advocated to limit use of broad spectrum antibiotics and treatment duration. What is Known: • Magnetic resonance imaging and sonography have the best sensitivity for detection of acute osteomyelitis and septic arthritis in children. • Systematic use of blood cultures, tissue cultures and nucleic acid testing improves pathogen detection in children with acute osteomyelitis and septic arthritis. What is New: • The added value of imaging modalities other than magnetic resonance and sonography for detection of osteomyelitis and septic arthritis is limited, and their routine use should be questioned. • Despite availability of optimal pathogen detection methods, missed opportunities to improve pathogen detection are frequent.
journal_name
Eur J Pediatrjournal_title
European journal of pediatricsauthors
Manz N,Krieg AH,Heininger U,Ritz Ndoi
10.1007/s00431-018-3157-3subject
Has Abstractpub_date
2018-07-01 00:00:00pages
1071-1080issue
7eissn
0340-6199issn
1432-1076pii
10.1007/s00431-018-3157-3journal_volume
177pub_type
杂志文章abstract::Chronic hepatitis B virus infection is among the most common causes of chronic liver disease in children. The aim of this study was to document prospectively our experiences related to lamivudine and high-dose interferon-alpha2a combination in naïve, e antigen positive, chronic hepatitis B virus infection treatment in...
journal_title:European journal of pediatrics
pub_type: 临床试验,杂志文章
doi:10.1007/s00431-006-0220-2
更新日期:2007-03-01 00:00:00
abstract::The neonatal early onset sepsis (EOS) calculator is a novel tool for antibiotic stewardship in newborns, associated with a reduction of empiric antibiotic treatment for suspected EOS. We studied if implementation of the EOS calculator results in less healthcare utilization and lower financial costs of suspected EOS. F...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-019-03510-9
更新日期:2020-05-01 00:00:00
abstract::Iliac vessel disruption following blunt trauma is an unusual presentation, particularly in the absence of an orthopaedic injury. We present the unique case of a 14-year-old boy who sustained a blunt bicycle handlebar impalement that resulted in complete transection of the external iliac artery and laceration of the ex...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-012-1767-8
更新日期:2012-12-01 00:00:00
abstract::Perinatal transmission remains the main cause of HIV infection in the pediatric population. Treatment of HIV-infected children has become less of a problem in resource-rich countries with a remarkable decrease of perinatal infections, resulting in an effective prevention of mother-to-child transmission and antiretrovi...
journal_title:European journal of pediatrics
pub_type: 杂志文章,评审
doi:10.1007/s00431-008-0914-8
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:The treatment of complicated urinary tract infection in children is still a matter of debate. In our hospital, antimicrobial treatment is initiated intravenously, and the duration of this treatment is adapted according to the results of a Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy. AIM:This study wa...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-013-2024-5
更新日期:2013-09-01 00:00:00
abstract:UNLABELLED:We describe the case of a boy with steroid sensitive nephrotic syndrome and left pulmonary artery thrombo-embolism. clinical presentation initially suggested sepsis and respiratory signs were minor. Treatment with tissue plasminogen activator infused into the pulmonary artery was successful. CONCLUSION:Pulm...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s004310050684
更新日期:1997-08-01 00:00:00
abstract::To evaluate the feasibility and clinical usefulness of immunocytochemical detection of bone marrow metastases in neuroblastoma, we studied bone marrow samples from patients undergoing intensive therapy, followed in the majority of cases by autologous bone marrow rescue. Two monoclonal antibodies were used in an indire...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF00442474
更新日期:1988-08-01 00:00:00
abstract::The triad of adrenocortical insufficiency with alacrima and achalasia is an unusual disease entity in paediatrics. The association of autonomic and peripheral neuropathies has more commonly been reported in older individuals. We describe four children (two siblings) with this disorder, aged between 3 and 6 years at di...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF01972967
更新日期:1995-01-01 00:00:00
abstract:UNLABELLED:The purpose of this study was to assess how much of the variance in intellectual outcome at 2 and 6 years of age could be attributed to treatment variables in children with congenital hypothyroidism, and which of the parameters used for monitoring treatment predicted later development. Forty-five children, e...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF01955261
更新日期:1996-05-01 00:00:00
abstract::This article summarizes some research on the development of motion perception in early infancy. The sensitivity for slow and rapid motion was studied with 1-month-old and 3-month-old babies. The findings suggest that there are different developmental courses for the detection of slow and rapid motion. The ability to d...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF02191506
更新日期:1995-01-01 00:00:00
abstract::The objectives of this study were to determine if any specific clinical signs, symptoms, or comorbidities could reliably predict underlying feeding difficulty and need for further evaluation (i.e., video swallow study, VSS) in infants with Down syndrome, to establish the prevalence of gastrostomy tube placement (G-tub...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-020-03591-x
更新日期:2020-06-01 00:00:00
abstract:UNLABELLED:We describe the case of a 6-year-old girl brought to the emergency department for the sudden onset of anticholinergic syndrome after the ingestion of a few home-made partially debittered lupine beans. She complained of blurry vision, headache, photophobia and nausea. No specific treatment was needed, and the...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-013-2088-2
更新日期:2014-12-01 00:00:00
abstract::In a German pediatric oncology unit, the attending physicians diagnosed 27 cases of Clostridium difficile-associated disease (CDI) from January 01, 2010 to October 31, 2013. This refers to a CDI incidence density of 2.0/1000 inpatient days. According to the hospital hygiene standard, symptomatic patients with CDI were...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-017-3070-1
更新日期:2018-03-01 00:00:00
abstract::Twenty patients with rheumatoid arthritis or Still's disease associated with growth failure were treated with human growth hormone, 7.5 to 17 U/m2 body surface per week. Five patients did not respond with better growth. In the remainder the mean growth rate increased from 1.9 cm/year (range: 0 to 3.3) to 6.2 cm/year (...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF00441894
更新日期:1979-01-18 00:00:00
abstract::Pediatricians' job performance, work engagement, and job satisfaction are essential for both the individual physician and quality of care for their little patients and parents. Therefore, it is important to maintain or possibly augment pediatricians' individual and professional competencies. In this study, we develope...
journal_title:European journal of pediatrics
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00431-016-2777-8
更新日期:2016-12-01 00:00:00
abstract::Indomethacin treatment for 1 week monitored by drug level determinations was evaluated in 32 preterm infants with symptomatic patent ductus arteriosus (sPDA). Inter- and intra-individual indomethacin dispositions varied considerably with the need for marked dosage adjustments to maintain the drug level within the prop...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF02343219
更新日期:1987-03-01 00:00:00
abstract:UNLABELLED:This prospective clinical case-control study describes the effect of an inpatient multicomponent treatment programme for obese children and adolescents on their weight and psychological well being. We studied 38 patients and 38 controls on the waiting list, matched for age and gender, referred because of obe...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-003-1155-5
更新日期:2003-06-01 00:00:00
abstract::An adapted cow's milk formula with or without supplemental taurine (480 mumol/l) was fed for 16 weeks to 20 low-birth-weight infants. In the 2nd and 16th weeks of life, respectively, the following parameters were determined: growth, sonography of heart and brain, ECG, EEG, neurological development and the taurine conc...
journal_title:European journal of pediatrics
pub_type: 临床试验,杂志文章
doi:10.1007/BF00442699
更新日期:1988-04-01 00:00:00
abstract:UNLABELLED:Five neonates who suffered from an unexpected long period of respiratory failure, muscular hypotonia, and drowsiness were observed in a retrospective study. Prior to this general depression, unusually high doses of diazepam were administered to all patients via intravenous bolus injection. Serum levels of di...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s004310100745
更新日期:2001-06-01 00:00:00
abstract::Metabolic liver diseases (MLD) are an important group of disorders presenting with neonatal cholestasis (NC). The spectrum of liver involvement is wide and the presumptive diagnosis is traditionally based on clinical and laboratory findings. Recently, next-generation sequencing (NGS) panels have emerged as an appealin...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-019-03328-5
更新日期:2019-04-01 00:00:00
abstract::The involvement of minors in clinical research is inevitable to catch up with the lack of drugs labeled for pediatric use. To encourage the responsible conduct of pediatric clinical trials in the EU, an extensive legal framework has been developed over the past decade in which the practical, ethical, legal, social, an...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-008-0915-7
更新日期:2009-10-01 00:00:00
abstract:UNLABELLED:In patients with Henoch-Schönlein purpura (HSP) presenting with severe gastro-intestinal (GI) symptoms, IgA deposition was studied in endoscopically obtained mucosal biopsies. A total number of 11 patients (male, 7; female, 4) were enrolled in this study; 7 patients underwent upper GI endoscopy and biopsy 1 ...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF02075757
更新日期:1996-02-01 00:00:00
abstract::An Arab Moslem kindred is reported in which six abnormal male fetuses were born in three closely related sibships. They had amelia, malformed head and other severe skeletal and visceral malformations. The similarities and differences between the developmental and inherent characteristics found in our patients and in f...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF00441792
更新日期:1985-11-01 00:00:00
abstract:UNLABELLED:Our aim was to determine whether the chest radiograph appearance at 7 days predicted chronic lung disease development (oxygen dependency at 36 weeks post-menstrual age) or death before discharge and if it was a better predictor than readily available clinical data. Two consecutive studies were performed. In ...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-003-1332-6
更新日期:2004-01-01 00:00:00
abstract::Clinical and EEG family data of 140 cases with early childhood epilepsy with absences are presented. The aim of the study was to evaluate, whether the occurrence of generalized tonic clonic seizures (GTCS) as a presenting symptom might correlate with family data, i.e. whether there are indications of heterogeneity. On...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF01956423
更新日期:1994-05-01 00:00:00
abstract::We aimed to describe the experiences of children and adolescents with congenital heart disease (CHD). Electronic databases were searched until August 2016. Qualitative studies of children's perspectives on CHD were included. Data was extracted using thematic synthesis. From 44 studies from 12 countries involving 995 c...
journal_title:European journal of pediatrics
pub_type: 杂志文章,评审
doi:10.1007/s00431-017-3081-y
更新日期:2018-03-01 00:00:00
abstract::The effects of perinatal problems on red cell phosphate metabolism were studied in two groups of infants (preterms B and fullterms D) during the first month of life. All infants started milk feeding from day three after birth. The results were compared to those of healthy preterms (A) and fullterms (C), respectively. ...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-007-0464-5
更新日期:2008-02-01 00:00:00
abstract:UNLABELLED:Newborn screening for cystic fibrosis (CF), a chronic progressive disease affecting mucus viscosity, has been beneficial in both improving life expectancy and the quality of life for individuals with CF. In New York State from 2007 to 2012 screening for CF involved measuring immunoreactive trypsinogen (IRT) ...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-015-2616-3
更新日期:2016-02-01 00:00:00
abstract::The purpose of this study was to determine the percentiles of interpopliteal distance to diagnose bowleg in 0-6 year-old children. Measurement of interpopliteal distance is a simple but valuable indicator in clinical examination to diagnose bowleg. We analyzed data from the anthropometry of Turkish children aged 0-6 y...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-011-1414-9
更新日期:2011-09-01 00:00:00
abstract::Patients with Turner syndrome (n = 33) were subjected to a sequential oestrogen/gestagen replacement therapy (21 days 2 mg oestradiol valerate plus 0.5 mg norgestrel for 10 days) for 1-4 years. In individuals aged 12-17 years, growth velocities before treatment ranged between 2.9 and 1.9 cm/year and increased to 6.8-3...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF00439400
更新日期:1986-09-01 00:00:00