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Nonbacterial and bacterial osteomyelitis in children: a case–control retrospective study
PURPOSE: Osteomyelitis is a group of bone infectious (bacterial osteomyeilitis—BO) and noninfectious inflammatory diseases (nonbacterial osteomyelitis—NBO) with similar clinical, radiology, and laboratory features. Many patients with NBO are misdiagnosed as BO and receive unnecessary antibiotics and...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10188934/ https://www.ncbi.nlm.nih.gov/pubmed/37206973 http://dx.doi.org/10.3389/fped.2023.1067206 |
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author | Kostik, Mikhail M. Maletin, Alexey S. Petukhova, Veronika V. Mushkin, Alexander Yu. |
author_facet | Kostik, Mikhail M. Maletin, Alexey S. Petukhova, Veronika V. Mushkin, Alexander Yu. |
author_sort | Kostik, Mikhail M. |
collection | PubMed |
description | PURPOSE: Osteomyelitis is a group of bone infectious (bacterial osteomyeilitis—BO) and noninfectious inflammatory diseases (nonbacterial osteomyelitis—NBO) with similar clinical, radiology, and laboratory features. Many patients with NBO are misdiagnosed as BO and receive unnecessary antibiotics and surgery. Our study aimed to compare clinical and laboratory features of NBO and BO in children, to define key discriminative criteria, and to create an NBO diagnostic score (NBODS). METHODS: The retrospective multicenter cohort study included clinical, laboratory, and instrumental information about histologically confirmed NBO (n = 91) and BO (n = 31). The variables allowed us to differentiate both conditions used to construct and validate the NBO DS. RESULTS: The main differences between NBO and BO are as follows: onset age—7.3 (2.5; 10.6) vs. 10.5 (6.5; 12.7) years (p = 0.03), frequency of fever (34.1% vs. 90.6%, p = 0.0000001), symptomatic arthritis (67% vs. 28.1%, p = 0.0001), monofocal involvement (28.6% vs. 100%, p = 0.0000001), spine (32% vs. 6%, p = 0.004), femur (41% vs. 13%, p = 0.004), foot bones (40% vs. 13%, p = 0.005), clavicula (11% vs. 0%, p = 0.05), and sternum (11% vs. 0%, p = 0.039) involvement. The following four criteria are included in the NBO DS: CRP ≤ 55 mg/l (56 points), multifocal involvement (27 points), femur involvement (17 points), and neutrophil bands ≤ 220 cell/μl (15 points). The sum > 17 points allowed to differentiate NBO from BO with a sensitivity of 89.0% and a specificity of 96.9%. CONCLUSION: The diagnostic criteria may help discriminate NBO and BO and avoid excessive antibacterial treatment and surgery. |
format | Online Article Text |
id | pubmed-10188934 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-101889342023-05-18 Nonbacterial and bacterial osteomyelitis in children: a case–control retrospective study Kostik, Mikhail M. Maletin, Alexey S. Petukhova, Veronika V. Mushkin, Alexander Yu. Front Pediatr Pediatrics PURPOSE: Osteomyelitis is a group of bone infectious (bacterial osteomyeilitis—BO) and noninfectious inflammatory diseases (nonbacterial osteomyelitis—NBO) with similar clinical, radiology, and laboratory features. Many patients with NBO are misdiagnosed as BO and receive unnecessary antibiotics and surgery. Our study aimed to compare clinical and laboratory features of NBO and BO in children, to define key discriminative criteria, and to create an NBO diagnostic score (NBODS). METHODS: The retrospective multicenter cohort study included clinical, laboratory, and instrumental information about histologically confirmed NBO (n = 91) and BO (n = 31). The variables allowed us to differentiate both conditions used to construct and validate the NBO DS. RESULTS: The main differences between NBO and BO are as follows: onset age—7.3 (2.5; 10.6) vs. 10.5 (6.5; 12.7) years (p = 0.03), frequency of fever (34.1% vs. 90.6%, p = 0.0000001), symptomatic arthritis (67% vs. 28.1%, p = 0.0001), monofocal involvement (28.6% vs. 100%, p = 0.0000001), spine (32% vs. 6%, p = 0.004), femur (41% vs. 13%, p = 0.004), foot bones (40% vs. 13%, p = 0.005), clavicula (11% vs. 0%, p = 0.05), and sternum (11% vs. 0%, p = 0.039) involvement. The following four criteria are included in the NBO DS: CRP ≤ 55 mg/l (56 points), multifocal involvement (27 points), femur involvement (17 points), and neutrophil bands ≤ 220 cell/μl (15 points). The sum > 17 points allowed to differentiate NBO from BO with a sensitivity of 89.0% and a specificity of 96.9%. CONCLUSION: The diagnostic criteria may help discriminate NBO and BO and avoid excessive antibacterial treatment and surgery. Frontiers Media S.A. 2023-05-03 /pmc/articles/PMC10188934/ /pubmed/37206973 http://dx.doi.org/10.3389/fped.2023.1067206 Text en © 2023 Kostik, Maletin, Petukhova and Mushkin. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Kostik, Mikhail M. Maletin, Alexey S. Petukhova, Veronika V. Mushkin, Alexander Yu. Nonbacterial and bacterial osteomyelitis in children: a case–control retrospective study |
title | Nonbacterial and bacterial osteomyelitis in children: a case–control retrospective study |
title_full | Nonbacterial and bacterial osteomyelitis in children: a case–control retrospective study |
title_fullStr | Nonbacterial and bacterial osteomyelitis in children: a case–control retrospective study |
title_full_unstemmed | Nonbacterial and bacterial osteomyelitis in children: a case–control retrospective study |
title_short | Nonbacterial and bacterial osteomyelitis in children: a case–control retrospective study |
title_sort | nonbacterial and bacterial osteomyelitis in children: a case–control retrospective study |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10188934/ https://www.ncbi.nlm.nih.gov/pubmed/37206973 http://dx.doi.org/10.3389/fped.2023.1067206 |
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