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Title: Osteomyelitis in immunocompromised children and neonates, a case series
Authors: Foong, Bryan
Wong, Kenneth Pak Leung
Jeyanthi, Carolin Joseph
Li, Jiahui
Lim, Kevin Boon Leong
Tan, Natalie Woon Hui
Keywords: Science::Medicine
Issue Date: 2021
Source: Foong, B., Wong, K. P. L., Jeyanthi, C. J., Li, J., Lim, K. B. L. & Tan, N. W. H. (2021). Osteomyelitis in immunocompromised children and neonates, a case series. BMC Pediatrics, 21(1), 568-.
Journal: BMC Pediatrics 
Abstract: Background: Osteomyelitis in immunocompromised children can present differently from immunocompetent children and can cause devastating sequelae if treated inadequately. We aim to review the aetiology, clinical profile, treatment and outcomes of immunocompromised children with osteomyelitis. Methods: Retrospective review of all immunocompromised children aged < 16 years and neonates admitted with osteomyelitis in our hospital between January 2000 and January 2017, and referred to the Paediatric Infectious Disease Service. Results: Fourteen patients were identified. There were 10 boys (71%), and the median age at admission was 70.5 months (inter-quartile range: 12.3–135.0 months). Causal organisms included, two were Staphylococcus aureus, two were Mycobacterium bovis (BCG), and one each was Mycobacterium tuberculosis, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Burkholderia pseudomallei and Rhizopus sp. One patient had both Clostridium tertium and Clostridium difficile isolated. Treatment involved appropriate antimicrobials for a duration ranging from 6 weeks to 1 year, and surgery in 11 patients (79%). Wherever possible, the patients received treatment for their underlying immunodeficiency. For outcomes, only three patients (21%) recovered completely. Five patients (36%) had poor bone growth, one patient had recurrent discharge from the bone and one patient had palliative care for underlying osteosarcoma. Conclusions: Although uncommon, osteomyelitis in immunocompromised children and neonates can be caused by unusual pathogens, and can occur with devastating effects. Treatment involves prolonged administration of antibiotics and surgery. Immune recovery also seems to be an important factor in bone healing.
ISSN: 1471-2431
DOI: 10.1186/s12887-021-03031-1
Schools: Lee Kong Chian School of Medicine (LKCMedicine) 
Organisations: Yong Loo Lin School of Medicine, National University of Singapore
Duke-National University of Singapore Medical School
KK Women’s and Children’s Hospital
Rights: © The Author(s) 2021. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver (http://creativeco applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Fulltext Permission: open
Fulltext Availability: With Fulltext
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