Clinical Analysis Of 20 Cases Of Neonatal Osteomyelitis

Objective Analysis of osteomyelitis neonatal clinical characteristics,diagnosis and treatment points.Methods A retrospective analysis of the clinical features of Anhui Children's Hospital Neonatal Critical Care Medicine 20 cases of osteomyelitis,imaging findings,treatment and prognosis.Results 20 cases,male 12 cases,female 8 cases,age at 6 days-28 days,Days in hospital: 14 days-45 days.Symptom as irritability or mental poor,poor diet in 19 cases,14 cases of fever,7 cases of limb rejection,11 cases of local swelling,More than 85% of the children have more than two kinds of symptoms.All 20 cases of patients with blood culture and lesion pus culture,blood culture positive cases were 11 cases(1 cases of Escherichia coli,3 cases of methicillin sensitive Staphylococcus aureus,5 cases of methicillin resistant Staphylococcus aureus,1 cases of Enterobacter cloacae,1 cases of Pseudomonas aeruginosa);Pus culture positive in 20 cases(2 cases of Escherichia coli,6 cases of methicillin sensitive Staphylococcus aureus,8 cases of methicillin resistant Staphylococcus aureus,2 cases of Pseudomonas aeruginosa,1 cases of Enterobacter cloacae,1 case of Staphylococcus schleiferi),1 cases of Pseudomonas aeruginosa osteomyelitis patients progress to septic shock,multiple organ failure leading to death.In this group,the majority of children X-ray have changed significantly in the course of the first 10-14 days;50% children with CT showed bone erosion and destruction in the lesions after 1 weeks;30% patients with MRI can be found in the earliest bone marrow lesions of bone infection third days.7 cases did not form the bone marrow cavity and the periosteum abscess,the treatment effect is good,the limb movement is normal.13 cases of patients with antibiotics in the treatment of 1-2 days is not significant,7 cases of MRI tips to form a bone marrow cavity abscess,bone cortex drilling VSD drainage;6 cases of patients with the formation of the periosteum abscess,the use of abscess incision VSD drainage,but there are 3 cases of bone marrow cavity abscess progress,bone destruction,once again to the bone cortex drilling drainage.There were 2 cases of hip joint lesion in 13 cases,2 cases of femoral head necrosis caused metaphyseal epiphyseal plate,damage,cause limb shortening.1 cases died due to septic shock and multiple organ failure.The other 8 cases were treated by anti infection and surgical treatment,and the treatment effect was good.Conclusion Although neonatal acute osteomyelitis are rare.If misdiagnosed,missed the best treatment time might be left serious sequelae.