Clinical analysis of 56 cases of neonatal osteomyelitis / 中国新生儿科杂志

ABSTRACT

Objective:To study the clinical characteristics, pathogens, treatments and prognosis of neonatal osteomyelitis.Methods:From May 2015 to October 2019, infants admitted to our hospital and diagnosed with neonatal osteomyelitis were retrospectively studied. Clinical characteristics, laboratory examinations, treatments and prognosis were analyzed.Results:A total of 56 cases with neonatal osteomyelitis were included, including 39 males and 17 females. The time of onset was 1~28 d after birth, with 66.1% during 14~28 d. 62.5% (35/56) patients were hospitalized because of limited limb movement and crying during passive motion. Femur was involved in 57.1% (32/56) patients and 76.8% (43/56) had two or more bones involvement. All patients had local symptoms, including local swelling (94.6%), local tenderness (94.6%) and increased skin temperature (83.9%). 40 patients (71.4%) had increased white blood cell count (WBC) and 28 (50.0%) showed increased C-reactive protein (CRP). Staphylococcus aureus was the most common pathogen in blood cultures (25.0%) and in local pus cultures (40.9%). Klebsiella pneumoniae was the most common pathogen in bone marrow cultures (33.3%).11 patients (19.6%) were treated conservatively using antibiotics and 45 patients (80.4%) required surgical treatments. 48 patients were followed up. 45 had good prognosis, 1 patient had malposition, 1 patient had disparity of the legs(the affected side was longer) and 1 patient had genu valgum.Conclusions:The early manifestations of neonatal osteomyelitis are nonspecific. For neonates with suspected osteomyelitis, early laboratory and imaging examinations are recommended. Early diagnosis and timely treatment may help reduce sequelae.