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Primary Fibular Osteomyelitis in Children: A Systematic Review

Osteomyelitis of the fibula is rare and is especially rare in children. The published literature is limited to case series and is thus lacking a comprehensive description of the disease. The purpose of this systematic review is to provide the first comprehensive summary of the demographics, presenti...

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Autores principales: Nikkhahmanesh, Nia, Vij, Neeraj, Ranade, Ashish S, Belthur, Mohan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10398615/
https://www.ncbi.nlm.nih.gov/pubmed/37546085
http://dx.doi.org/10.7759/cureus.41345
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author Nikkhahmanesh, Nia
Vij, Neeraj
Ranade, Ashish S
Belthur, Mohan
author_facet Nikkhahmanesh, Nia
Vij, Neeraj
Ranade, Ashish S
Belthur, Mohan
author_sort Nikkhahmanesh, Nia
collection PubMed
description Osteomyelitis of the fibula is rare and is especially rare in children. The published literature is limited to case series and is thus lacking a comprehensive description of the disease. The purpose of this systematic review is to provide the first comprehensive summary of the demographics, presenting symptoms, laboratory values, microbiology, and treatment results of osteomyelitis of the fibula in children based on the existing literature. This institutional review board (IRB)-exempt systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) guidelines. Three search engines were used for a total of 239 studies. Twenty-six studies were screened by full text. Twelve articles underwent a quantitative analysis. Due to limited data and heterogenous reporting, the data were summarized descriptively. The methodologic quality of the studies was evaluated based on the Newcastle-Ottawa scale. The average age was 7.71±3.49 years, and males comprised 57% of the 21 cases. The most common presenting symptoms were fever (86%), antalgic gait (57%), and localized tenderness (81%). The most common site of involvement was the distal third of the fibula (90%). The average C-reactive protein (CRP) was 90.1±38.3 mg/L, and the average erythrocyte sedimentation rate (ESR) was 58.8±21.2 mm/hour. Staphylococcus aureus was the most cultured pathogen reported in 10/21 cases (48%). Open surgery was performed in 17/21 cases (81%), and there were no reported complications. Fever, antalgic gait, and localized tenderness should raise the index of suspicion. Prompt laboratory and radiographic evaluations can help reduce delays in diagnosis and improve outcomes. Blood and tissue cultures are currently performed in about half of the cases. Improvement in our microbiologic diagnosis has the potential to improve antibiotic selection. Local methicillin-resistant Staphylococcus aureus (MRSA) prevalence must be taken into consideration when starting empiric antibiotic treatment. Surgical treatment is often required with a low complication rate. The clinical and laboratory parameters identified in this study have the potential for integration into a composite clinical score.
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spelling pubmed-103986152023-08-04 Primary Fibular Osteomyelitis in Children: A Systematic Review Nikkhahmanesh, Nia Vij, Neeraj Ranade, Ashish S Belthur, Mohan Cureus Pediatrics Osteomyelitis of the fibula is rare and is especially rare in children. The published literature is limited to case series and is thus lacking a comprehensive description of the disease. The purpose of this systematic review is to provide the first comprehensive summary of the demographics, presenting symptoms, laboratory values, microbiology, and treatment results of osteomyelitis of the fibula in children based on the existing literature. This institutional review board (IRB)-exempt systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) guidelines. Three search engines were used for a total of 239 studies. Twenty-six studies were screened by full text. Twelve articles underwent a quantitative analysis. Due to limited data and heterogenous reporting, the data were summarized descriptively. The methodologic quality of the studies was evaluated based on the Newcastle-Ottawa scale. The average age was 7.71±3.49 years, and males comprised 57% of the 21 cases. The most common presenting symptoms were fever (86%), antalgic gait (57%), and localized tenderness (81%). The most common site of involvement was the distal third of the fibula (90%). The average C-reactive protein (CRP) was 90.1±38.3 mg/L, and the average erythrocyte sedimentation rate (ESR) was 58.8±21.2 mm/hour. Staphylococcus aureus was the most cultured pathogen reported in 10/21 cases (48%). Open surgery was performed in 17/21 cases (81%), and there were no reported complications. Fever, antalgic gait, and localized tenderness should raise the index of suspicion. Prompt laboratory and radiographic evaluations can help reduce delays in diagnosis and improve outcomes. Blood and tissue cultures are currently performed in about half of the cases. Improvement in our microbiologic diagnosis has the potential to improve antibiotic selection. Local methicillin-resistant Staphylococcus aureus (MRSA) prevalence must be taken into consideration when starting empiric antibiotic treatment. Surgical treatment is often required with a low complication rate. The clinical and laboratory parameters identified in this study have the potential for integration into a composite clinical score. Cureus 2023-07-04 /pmc/articles/PMC10398615/ /pubmed/37546085 http://dx.doi.org/10.7759/cureus.41345 Text en Copyright © 2023, Nikkhahmanesh et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Pediatrics
Nikkhahmanesh, Nia
Vij, Neeraj
Ranade, Ashish S
Belthur, Mohan
Primary Fibular Osteomyelitis in Children: A Systematic Review
title Primary Fibular Osteomyelitis in Children: A Systematic Review
title_full Primary Fibular Osteomyelitis in Children: A Systematic Review
title_fullStr Primary Fibular Osteomyelitis in Children: A Systematic Review
title_full_unstemmed Primary Fibular Osteomyelitis in Children: A Systematic Review
title_short Primary Fibular Osteomyelitis in Children: A Systematic Review
title_sort primary fibular osteomyelitis in children: a systematic review
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10398615/
https://www.ncbi.nlm.nih.gov/pubmed/37546085
http://dx.doi.org/10.7759/cureus.41345
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