Abstract:
:Diskitis, an inflammation of the intervertebral disk, is generally attributable to Staphylococcus aureus and rarely Staphylococcus epidermidis, Kingella kingae, Enterobacteriaciae, and Streptococcus pneumoniae. In many cases, no bacterial growth is obtained from infected intervertebral discs. Although anaerobic bacteria were recovered from adults with spondylodiscitis, these organisms were not reported before from children. The recovery of anaerobic bacteria in 2 children with diskitis is reported. Patient 1. A 10-year-old male presented with 6 weeks of low back pain and 2 weeks of low-grade fever and abdominal pain. Physical examination was normal except for tenderness to percussion over the spine between thoracic vertebra 11 and lumbar vertebra 2. The patient had a temperature of 104 degrees F. Laboratory tests were within normal limits, except for erythrocyte sedimentation rate (ESR), which was 58 mm/hour. Blood culture showed no growth. Magnetic resonance imaging with gadolinium contrast revealed minimal inflammatory changes in the 12th thoracic vertebra/first lumbar vertebra disk. There was no other abnormality. A computed tomography (CT)-guided aspiration of the disk space yielded bloody material, which was sent for aerobic and anaerobic cultures. Gram stain showed numerous white blood cells and Gram-positive cocci in chains. Cultures for anaerobic bacteria yielded heavy growth of Peptostreptococcus magnus, which was susceptible to penicillin, clindamycin, and vancomycin. The patient was treated with intravenous penicillin 600 000 units every 6 hours for 3 weeks, and then oral amoxicillin, 500 mg every 6 hours for 3 weeks. The back pain resolved within 2 weeks, and the ESR returned to normal at the end of therapy. Follow-up for 3 years showed complete resolution of the infection. Patient 2. An 8-year-old boy presented with low back pain and low-grade fever, irritability, and general malaise for 10 days. He had had an upper respiratory tract infection with sore throat 27 days earlier, for which he received no therapy. The patient had a temperature of 102 degrees F, and physical examination was normal except for tenderness to percussion over the spine between the second and fourth lumbar vertebrae. Laboratory tests were normal, except for the ESR (42 mm/hour). Radiographs of the spine showed narrowing of the third to fourth lumbar vertebra disk space and irregularity of the margins of the vertebral endplates. A CT scan revealed a lytic bone lesion at lumbar vertebra 4, and bone scan showed an increase uptake of (99m)technetium at the third to fourth lumbar vertebra disk space. CT-guided aspiration of the disk space yielded cloudy nonfoul-smelling material, which was sent for aerobic and anaerobic cultures. Gram stain showed numerous white blood cells and fusiform Gram-negative bacilli. Anaerobic culture grew light growth of Fusobacterium nucleatum. The organism produced beta-lactamase and was susceptible to ticarcillin-clavulanate, clindamycin, metronidazole, and imipenem. Therapy with clindamycin 450 mg every 8 hours was given parenterally for 3 weeks and orally for 3 weeks. Back pain resolved within 2 weeks. A 2-year follow-up showed complete resolution and no recurrence. This report describes, for the first time, the isolation of anaerobic bacteria from children with diskitis. The lack of their recovery in previous reports and the absence of bacterial growth in over two third of these studies may be caused by the use of improper methods for their collection, transportation, and cultivation. Proper choice of antimicrobial therapy for diskitis can be accomplished only by identification of the causative organisms and its antimicrobial susceptibility. This is of particular importance in infections caused by anaerobic bacteria that are often resistant to antimicrobials used to empirically treat diskitis. This was the case in our second patient, who was infected by F nucleatum, which was resistant to beta-lactam antibiotics. The origin of the anaerobic bacteria causing the infection in our patient is probably of endogenous nature. The presence of abdominal pain in the first child may have been attributable to a subclinical abdominal pathothology. The preceding pharyngitis in the second patient may have been associated with a potential hematogenous spread of F nucleatum. P magnus has been associated with bone and joint infections. This report highlights the importance of obtaining disk space culture for aerobic and anaerobic bacteria from all children with diskitis. Future prospective studies are warranted to elucidate the role of anaerobic bacteria in diskitis in children.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Brook Idoi
10.1542/peds.107.2.e26subject
Has Abstractpub_date
2001-02-01 00:00:00pages
E26issue
2eissn
0031-4005issn
1098-4275journal_volume
107pub_type
杂志文章相关文献
PEDIATRICS文献大全abstract:BACKGROUND:Little is known about the impact of providing health insurance to uninsured children who have asthma or other chronic diseases. OBJECTIVES:To evaluate the association between health insurance and the utilization of health care and the quality of care among children who have asthma. DESIGN:Before-and-during...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:To assess measures of puberty-presence of pubic hair, breast development, and menarche-for 3 racial/ethnic groups of girls in the United States. METHODS:Using data from the Third National Health and Nutrition Examination Survey, this study sample was restricted to 1623 girls aged 8 to 16 years (466 non-Hispa...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.110.4.752
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVES:As part of the evaluation of the American Academy of Pediatrics (AAP) Community Access to Child Health (CATCH), to 1) identify, retrospectively, the actual chronology of activities undertaken through CATCH, and 2) review its antecedents within the AAP, and its predecessor program-Healthy Children. METHODS:K...
journal_title:Pediatrics
pub_type: 历史文章,杂志文章
doi:
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Gastric acidity is a major nonimmune defense mechanism against infections. The objective of this study was to investigate whether ranitidine treatment in very low birth weight (VLBW) infants is associated with an increased risk of infections, necrotizing enterocolitis (NEC), and fatal outcome....
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2011-0796
更新日期:2012-01-01 00:00:00
abstract::Male circumcision is a common procedure, generally performed during the newborn period in the United States. In 2007, the American Academy of Pediatrics (AAP) formed a multidisciplinary task force of AAP members and other stakeholders to evaluate the recent evidence on male circumcision and update the Academy's 1999 r...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2012-1989
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:Studies have indicated that internationally adopted children have an increased risk of developing precocious puberty, but no epidemiologic risk estimates have previously been calculated. We aimed to assess the risk of developing precocious puberty in intercountry adoptees, children immigrating with their fam...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2005-2939
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of 4 months of daily zinc supplementation on the incidence of severe and recurrent diarrhea in children 6 to 30 months of age. METHODS:A double-blind, randomized, placebo-controlled trial was conducted on children who were identified by a door-to-door survey to be aged 6 to 30 months a...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1542/peds.109.6.e86
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:To define the nature and frequency of brain injury and brain growth impairment in very preterm (VPT) infants by using MRI at term-equivalent age and to relate these findings to perinatal risk factors and 2-year neurodevelopmental outcomes. METHODS:MRI scans at term-equivalent age from 3 VPT cohorts (n = 325...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2013-2336
更新日期:2014-08-01 00:00:00
abstract::This article reviews current evidence for autism spectrum disorder (ASD) interventions for children aged <3 years, based on peer-reviewed articles published up to December 2013. Several groups have adapted treatments initially designed for older, preschool-aged children with ASD, integrating best practice in behaviora...
journal_title:Pediatrics
pub_type: 共识发展会议,杂志文章,实务指引
doi:10.1542/peds.2014-3667E
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:An increase in the incidence of systemic candidiasis (SC) followed a change in skin care for extremely low birth weight (ELBW) infants in our neonatal intensive care unit (NICU). We sought to determine whether the use of topical petrolatum ointment (TPO) for skin care of ELBW infants was associ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.105.5.1041
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Rates of adult women receiving contraceptive provision when simultaneously prescribed a known teratogen are alarmingly low. The prevalence of this behavior among pediatric providers and their adolescent patients is unknown. The objective of this study was to describe pediatric provider behavio...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2015-1454
更新日期:2016-01-01 00:00:00
abstract::A child with renal insufficiency was treated with the oral phosphate binder aluminum hydroxide from age 6 to 31 months. The prescribed dose of elemental aluminum varied from 31 to 108 mg/kg/d. Concurrently the patient developed vitamin D-resistant osteomalacia which failed to improve with parathyroidectomy. Encephalop...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract:BACKGROUND:Stevens-Johnson syndrome (SJS) is an uncommon, sporadic disease and outbreaks are rare. In November 2013, an outbreak of SJS was identified at Children's Hospital Colorado. METHODS:Outbreak cases were children aged 5-21 with a discharge diagnosis of SJS admitted from September 1 to November 30, 2013. Medica...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2015-0278
更新日期:2015-08-01 00:00:00
abstract::Our specific aim was to examine the efficacy and safety of long-term cholesterol-lowering diet and bile acid-binding resin therapy in 73 children heterozygous for familial hypercholesterolemia (FH). We prospectively followed accretion of height and weight in 40 FH children for 5.8 years on diet alone and in 33 FH chil...
journal_title:Pediatrics
pub_type: 杂志文章,收录出版
doi:
更新日期:1986-08-01 00:00:00
abstract:OBJECTIVE:Many organizations make efforts to identify future pediatric leaders, often focusing on chief residents (CRs). Identifying future leaders is an issue of great importance not only to the ultimate success of the organization but also to the profession. Because little is known regarding whether completing a CR p...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVE:Bronchiolitis is a major cause of infant morbidity and contributes to millions of dollars in health care costs. Care guidelines may cut costs by reducing unnecessary resource utilization. Through the implementation of a guideline, we sought to reduce unnecessary resource utilization and improve the value of c...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2013-1991
更新日期:2014-01-01 00:00:00
abstract::Beals syndrome, also known as congenital contractural arachnodactyly (Online Mendelian Inheritance in Man: 121050), is an autosomal dominant disorder caused by a mutation in FBN2 that is typically characterized by congenital contractures and arachnodactyly. It shares a number of phenotypic features with Loeys-Dietz sy...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2016-1281
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVES:Arab Americans have a lower risk for preterm birth than white Americans. We assessed factors that may contribute to the association between ethnicity and preterm birth risk in Michigan, the state with the largest concentration of Arab Americans in the United States. Factors assessed as potential contributors...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2008-1634
更新日期:2009-03-01 00:00:00
abstract::Severe methemoglobinemia resulting from the use of topical benzocaine has been reported in adults as a rare complication. Here we report a case of severe acquired methemoglobinemia resulting from topical use of benzocaine spray during diagnostic upper gastrointestinal endoscopy in a 3-year-old boy with repeated episod...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:10.1542/peds.2005-1952
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:In Rwanda, significant progress has been made in advancing access to antiretroviral therapy (ART) among youth. As availability of ART increases, adherence is critical for preventing poor clinical outcomes and transmission of HIV. The goals of the study are to (1) describe ART adherence and men...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2015-3235
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVES:To determine the prevalence of invasive bacterial infections (IBIs) and adverse events in afebrile infants with acute otitis media (AOM). METHODS:We conducted a 33-site cross-sectional study of afebrile infants ≤90 days of age with AOM seen in emergency departments from 2007 to 2017. Eligible infants were i...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2020-1571
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Making national comparisons of family experience of inpatient pediatric care has been limited by the lack of a publicly available survey. The Agency for Healthcare Research and Quality and Centers for Medicare & Medicaid Services commissioned development of the Child Hospital Consumer Assessment of Healthcar...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2016-3372
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:Free radical-induced postasphyxial reperfusion injury has been recognized as an important cause of brain tissue damage. We investigated the effect of high-dose allopurinol (ALLO; 40 mg/kg), a xanthine-oxidase inhibitor and free radical scavenger, on free radical status in severely asphyxiated newborns and on ...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章
doi:10.1542/peds.101.2.185
更新日期:1998-02-01 00:00:00
abstract::In this report we describe the outcome of a consensus meeting that occurred at the National Institutes of Health in Bethesda, Maryland, March 12 through 14, 2005. The meeting brought together 39 specialists from multiple clinical and research disciplines including developmental pediatrics, neurology, neurosurgery, ort...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2005-3016
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVE:To determine how growth of large for gestational age (LGA) preterm (PT) children was affected by their PT birth and their LGA status. METHODS:This is a community-based cohort study of 1302 PT and 489 full-term (FT) children, born 2002 and 2003. RESULTS:We found that growth in height, weight, and head circum...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2013-0985
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:The purpose of the study was to examine the relationship between self-reported sleep quality and sleep hygiene in Italian and American adolescents and to assess whether sleep-hygiene practices mediate the relationship between culture and sleep quality. METHODS:Two nonprobability samples were collected from p...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2004-0815H
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Extremely preterm infants are at risk for neurodevelopmental impairment (NDI). Early cranial ultrasound (CUS) is usual practice, but near-term brain MRI has been reported to better predict outcomes. We prospectively evaluated MRI white matter abnormality (WMA) and cerebellar lesions, and serial CUS adverse f...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1542/peds.2014-0898
更新日期:2015-01-01 00:00:00
abstract::Global developmental delay and intellectual disability are relatively common pediatric conditions. This report describes the recommended clinical genetics diagnostic approach. The report is based on a review of published reports, most consisting of medium to large case series of diagnostic tests used, and the proporti...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:10.1542/peds.2014-1839
更新日期:2014-09-01 00:00:00
abstract::Two patients with periobital cellulitis, one of whom also had buccal cellulitis, had violaceous discoloration of the skin. Blood cultures from both patients yielded Streptococcus pneumoniae. Therefore, pneumococci should be considered, in addition to Haemophilus influenzae, as possible causes of cellulitis with violac...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1978-10-01 00:00:00
abstract:OBJECTIVES:To assess characteristics associated with health care spending trends among child high resource users in Medicaid. METHODS:This retrospective analysis included 48 743 children ages 1 to 18 years continuously enrolled from 2009-2013 in 10 state Medicaid programs (Truven MarketScan Medicaid Database) also in ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2016-0682
更新日期:2016-10-01 00:00:00