Osteomyelitis in children: a description, causes, symptoms and features of treatment

Recently, children often began to diagnose such a disease as osteomyelitis. This is a purulent-necrotic process of an infectious nature that develops in the bones surrounding the soft tissues and bone marrow. This pathology is caused by bacteria that produce pus. If this disease takes on a chronic form, then the probability of bone deformation of the child's unformed skeleton is great.

Osteomyelitis in children most often affects the lower leg, thigh, jaw joints, humerus, vertebra. To protect the baby from the onset of adverse effects of this disease, it is necessary to limit the range of factors that cause such pathology.

Causes

This disease is more likely to affect boys than girls. This is due to the fact that they are much more mobile. In addition, odontogenic osteomyelitis in children is also found mainly in boys, as the cause of its development are injuries of the skeleton of the jaw, which can be obtained in fights or when falling.

Quite often the cause of the disease in children are such foci of purulent infection as impetigo, otitis, pyelonephritis, boils, burns, wounds. Also, the development of osteomyelitis leads to abscesses, dental caries, purulent angina, tonsillitis.

Penetrating into the body through damage to the skin, mucous membrane or lymphoid pharyngeal ring, the infection begins to spread with the help of the circulatory system. Most often, the causative agent of osteomyelitis is the bacteria of Staphylococcus aureus, which is found in 80% of cases. In the remaining 20% of patients, pathology is caused by streptococci, Escherichia coli, Salmonella, Pfeiffer's wand. In the body of infants, the bacterium penetrates through the umbilical wound.

Not all cases of bone is the source of inflammation. Spread on her infection can come from surrounding organs or soft tissues. It is quite possible and the opposite situation, when first the bone marrow is damaged, and then the adjacent tissues.

Symptoms of the disease

This pathology can manifest itself differently depending on the age of the child, his immunity and the affected bone site. In newborns and children a little older the disease affects their overall well-being. The child becomes sluggish, he has nervous anxiety, appetite disappears, high fever rises, pallor appears. Often the pathological condition is accompanied by diarrhea and vomiting.

If you observe the child, you can see that he begins to protect his limb, trying to not touch it or move it. The skin of the affected joint is often reddened. A few days later, redness and swelling begin to increase. If you do not start treatment immediately, suppurative metastases will appear on your entire body.

Acute hematogenous osteomyelitis in older children manifests itself in a more pronounced form. The development of inflammation occurs much more slowly, and reddening and swelling begin to appear only a week after the onset of the disease. If the treatment is not started in time, an intermuscular phlegmon may occur, which means that the inflammatory process gradually spreads to the surrounding soft tissues. In this case, surgical intervention is inevitable. With an intermuscular phlegmon in the first time there may be an improvement in the child's condition, but it is deceptive. Osteomyelitis in children can cause such formidable complications as purulent arthritis and sepsis.

The acute form of the disease in children after a while passes into a chronic, the lack of treatment which leads to death. Therefore, it is so important to diagnose this pathology in time and begin treatment.

Features of odontogenic osteomyelitis

This kind of pathology has its own peculiarities. From the gums and canals of the teeth, pus begins to appear, and the soft tissues of the face swell. Skin and mucous membranes are pale and dry, high fever rises, chills and general weakness appear. In young children, convulsions, vomiting, indigestion are noted. This indicates that the central nervous system begins to become irritated, as a strong intoxication of the organism develops. Odontogenic osteomyelitis of the jaw in children is protracted.

Features of the chronic form

This form of pathology is primary and secondary. The latter is characterized by remissions and exacerbations, alternating with each other. During the remission, the child does not complain about anything, but when the exacerbation starts, there is an increase in temperature, with palpation there is pain. It is possible to open a fistula with the formation of pus. Such periods can last for years, while the kidneys, liver and heart are affected.

Chronic osteomyelitis in children of a primary type occurs without a phase of exacerbation, and the onset of the disease has blurred symptoms. Minor pains do not have a clear localization. Most often, parents bring their children to the hospital only when there is an increase in pain or symptoms appear.

Diagnostics

It is very important to correctly diagnose this disease, since it strongly resembles rheumatism, purulent arthritis, Ewing's sarcoma with its symptoms .

At the very beginning of its development, osteomyelitis of the bones in children has such symptoms that can cause a doctor to suspect the formation of a malignant infection. Only correctly diagnosed leads to competent treatment, which guarantees a successful prognosis.

Treatment of the disease

If there is a pathology such as osteomyelitis (children), the treatment should take place with the participation of a pediatrician, a radiologist and other specialists. Most often, antibiotics are prescribed for this and the operation is performed.

Antibiotics should be used as soon as possible. First, a shock dose of these medicines is given to the child in order to stop the inflammation. Most often for these purposes prescribe drugs penicillin group. Taking antibiotics should be long, sometimes the course of treatment can last three months. The dose should be reduced gradually. Simultaneously, the child should be given medications for thrush, because antibiotics destroy the microflora. Sometimes surgical intervention may be required. In this case, open the abscess, remove pus and rinse the canal. The operation passes quickly enough with the use of local anesthesia. Sometimes doctors put drainage to remove fluid.

The main treatment for odontogenic osteomyelitis is a surgical intervention that involves the removal of the tooth that is the source of the infection. Under general anesthesia, an autopsy is performed on the subperiosteal abscesses. Pus sowing is performed to determine the sensitivity of microflora to antibiotics. During the surgical intervention, the wound is drained, after which detoxification therapy, antihistamines, antibiotics, calcium preparations, vitamins and non-specific immunomodulators are prescribed. The child should be given to drink as much water as possible and to feed him with plant and milk food.

Complications

Osteomyelitis in children can cause various complications. It can be:

• Defects of bones;
• Arthritis of the limbs;
• As a result of pinching of the spinal cord, the locomotor apparatus is injured;
• If the disease has hit the hip joint or children's legs, complete negligence occurs in neglected cases;
• There is instability of the joints;
• Bone growth is impaired;
• Secondary chronic osteomyelitis begins to develop, which subsequently leads to disruption of posture;
• There is a destructive dislocation;
• Osteomyelitis of the upper jaw, which is often diagnosed in boys, causes the formation of meningitis, which causes changes in the entire body.

Conclusion

Despite the fact that osteomyelitis in children causes quite serious complications, modern medicine is able to successfully treat this terrible disease, guaranteeing the most favorable prognosis. According to statistics, deaths are getting smaller every year. Parents should be more attentive to the health of their children, to ensure that the infection does not get into the injuries and injuries received, and to consult a doctor in a timely manner.