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OP-017 A newborn case with post-intervention osteomyelitis detected
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  1. Mine Dedeoğlu1,
  2. Halil İbrahim Yakut2,
  3. Seval Çevik Özen2,
  4. Tuğçe Özbilgiç Demiröz2
  1. 1Mardin Dargeçit Devlet Hastanesi
  2. 2Ankara Bilkent Şehir Hastanesi

Abstract

Aim In this study, a newborn case with osteomiyelitis will be presented.

Material and Method A case admitted to the pediatric emergency clinic of Ankara City Hospital is presented.

Results A 17-day-old female patient was brought to the pediatric emergency department with the complaint of not being able to move her left arm. She was brought to the emergency room when they noticed a pink color in the diaper. On admission, he was evaluated as dehydrated and intravenous access was attempted through the brachial vein. On physical examination, newborn reflexes were active, there was hyperemia, edema and tenderness in the left shoulder. The patient was admitted to the neonatal intensive care unit. Laboratory findings;white blood cell:21.110/mm³(7200–19200/mm3), platelet:768.000/mm³(230.000–520.000/mm3)were detected. C-reactive protein:140 mg/L(0–5), Interleukin-6:83.4 pg/ml(0–3,4 pg/mL )were detected. Methicillin Sensitive Staphylococcus Aureus was grown in blood culture. The patient was started Amikacin and Vancomycin treatment. Left shoulder magnetic resonance imaging;the imaging of the patient, who was evaluated have osteomiyelitis, showed that the integrity of the cortex of the left humeral head was impaired, there were dense, inflamed loculated fluid collections extending from the subcortical-intramedullary area to the glenohumoral joint, subperiosteal fluid around the humerus and intensity increases compatible with edema in the subcutaneosus soft tissues and muscle planes adjacent to the glenohumeral joint. It was compatible with. Amikacin was discontinued on the 15th day due to pediatric infection recommendation. A control MRI was taken at the 6th week of treatment. The osteomiyelitis findings in the follow up MRI regressed and the patient was discharged after completing the antibiotic treatment for 8 weeks.

Conclusions The incidence of osteomiyelitis in newborns is reported to be 0.1–0.3%. Findings in the neonatal period are nonspecific. The patient may present with complaints of restlessness, inability to move joints, fever, tachycardia, decreased sucking and tendency to sleep. When suspected, the patient should be evaluated with USG and MRI in addition to the routine septic screening protocol. Intravenous antibiotics should be started early, surgical debridement should be performed if necessary and the treatment should be continued for 6–8 weeks.

  • osteomiyelitis
  • osteoarticular infection
  • neonatal osteomyelitis
  • septic arthritis

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