Clinical Analysis Of Neonatal Osteomyelitis In 27 Cases

Objective:To expore the clinical features of acute osteomyelitis of neonate.Methods:A retrospective study was done about general date,clinical symptoms, laboratory examination, etiology, etradiologic features, treatment and prognosis of 27 neonates who were diagnosed with osteomyelitis in Children's Hospital Affliated to Chongqing University of Medical Sciences from January 2004 to December 2014.Results:Totally 27 neonates were enrolled. There were 19 male verse 8 female infants(ratio 2.4:1).19 (70.4%) babies were related to bacteraemia, the other eight (29.6%) cases were due to infection nearby. Limb bones are most commonly compromised.13 (48.1%) caseshad jointinvolvement. Local swelling, pain on touching the affected extremities and disorder of extremity's activity(pseudoparalysis) were most common clinical symptoms.24 patients got positve culture results from blood, pus or joint fluid samples. The most common pathogens were Staphylococcus aureus and Gram-negative bacteria. All babies accepted antibiotic treatment while 14 cases also underwent surgeries. At follow up ages from 3 months to 4 years of 16 patients, despite a 3 months patients with the bilateral femur and hip joint affected had the absence of active mobility of lower extremities, others had no complaints and a normal physical examination.Conclusion:Neonatal osteomyelitis is not a rare disease. Infections are usually transmitted by hematogenous pathways and may spread to the contiguous joints. Early diagnosis is rather challenging because the clinical signs and symptoms of this disease are subtle and/or atypical. More attention should be paid to the physical examination. Radiologyand bacteriologic culture should be carried out once osteomyelitis is suspected. Appropriate antibiotics and necessary surgery are important to avoid further damages as well as long-term sequelaes.