Non-Travmatik Akut Pseudomonas Aeruginosa Osteomiyeliti

Öz

Osteomiyelit, sıklıkla bakteriyel nedenli, kemik dokunun yıkım ve nekrozuna sebep olabilen bir enfeksiyon hastalığıdır. Çocuklarda çoğunlukla hematojen kaynaklı ortaya çıkar. Tüm yaş gruplarında izole edilen en sık etken Staphlyococcus aureus’tur. On altı yaşında kız hasta, sağ ayak başparmağında şişlik, ağrı, kızarıklık yakınmalarıyla başvurdu. Öncesinde travma öyküsü yoktu. Hastanın sağ ayak başparmağında eklem hareket kısıtlılığı, şişlik ve kızarıklık vardı, diğer sistem muayeneleri doğaldı. Laboratuvar bulgularında akut faz reaktanları yüksekti ancak lökositozu yoktu. MR görüntülemede periost reaksiyonu saptandı. Hastaya cerrahi debridman, tırnak rezeksiyonu ve yara örneklemesi yapıldı. Yara kültüründe Pseudomonas aeruginosa üredi. Literatürde travma öyküsü olmaksızın gelişen osteomiyelit vakalarında etken olarak Pseudomonas aeruginosa nadir olarak bildirilmiştir.

Anahtar Kelimeler

• Osteomiyelit
• Paronişi
• Ağrı
• Pseudomonas aeruginosa

Non-Traumatic Acute Pseudomonas Aeruginosa Osteomyelitis

Öz

Osteomyelitis is an infectious disease of bacterial origin, which can cause destruction and necrosis of bone tissue. It often occurs with hematogenous causes in children. The most common agent isolated in all age groups is Staphlyococcus aureus. A 16-year-old girl presented with complaints of swelling, pain and redness in the right big toe. She had no previous history of trauma. She had limited range of motion, swelling and redness in the right big toe, and other system examinations were normal. In the laboratory findings, acute phase reactants were high, but there was no leukocytosis. Periosteal reaction was detected on MR imaging. The patient underwent surgical debridement, nail resection and wound sampling. Pseudomonas aeruginosa was grown in the wound culture. In the literature, Pseudomonas aeruginosa has been reported rarely as a causative agent in cases of osteomyelitis without a history of trauma.

Anahtar Kelimeler

• Osteomyelitis
• Paronychia
• Pain
• Pseudomonas aeruginosa

Kaynakça

1. Funk SS, Copley LA. Acute Hematogenous Osteomyelitis in Children: Pathogenesis, Diagnosis, and Treatment. Orthop Clin North Am. 2017 Apr;48(2):199-208. doi: 10.1016/j.ocl.2016.12.007
2. Saavedra-Lozano J, Falup-Pecurariu O, Faust SN, et al. Bone and Joint Infections. Pediatr Infect Dis J. 2017 Aug;36(8):788-799. doi: 10.1097/INF.0000000000001635
3. Kaplan SL. Osteomyelitis in children. Infect Dis Clin North Am. 2005 Dec;19(4):787-97, vii. doi: 10.1016/j.idc.2005.07.006
4. Peltola H, Pääkkönen M. Acute osteomyelitis in children. N Engl J Med. 2014 Jan 23;370(4):352-60. doi: 10.1056/NEJMra1213956
5. Hoshina Y, Nakao H, Yoshida M, Kubota M, Ishiguro A. Calcaneal osteomyelitis caused by Pseudomonas aeruginosa without foot injury. Pediatr Int. 2021 May;63(5):601-602. doi: 10.1111/ped.14457
6. Azam MW, Khan AU. Updates on the pathogenicity status of Pseudomonas aeruginosa. Drug Discov Today. 2019 Jan;24(1):350-359. doi: 10.1016/j.drudis.2018.07.003
7. Kremers HM, Nwojo ME, Ransom JE, Wood-Wentz CM, Melton LJ 3rd, Huddleston PM 3rd. Trends in the epidemiology of osteomyelitis: a population-based study, 1969 to 2009. J Bone Joint Surg Am. 2015 May 20;97(10):837-45. doi: 10.2106/JBJS.N.01350
8. Dubey L, Krasinski K, Hernanz-Schulman M. Osteomyelitis secondary to trauma or infected contiguous soft tissue. Pediatr Infect Dis J. 1988 Jan;7(1):26-34. doi: 10.1097/00006454-198801000-00007

9. Thingsaker EE, Urbane UN, Pavare J. A Comparison of the Epidemiology, Clinical Features, and Treatment of Acute Osteomyelitis in Hospitalized Children in Latvia and Norway. Medicina (Kaunas). 2021 Jan 4;57(1):36. doi: 10.3390/medicina57010036
10. Dartnell J, Ramachandran M, Katchburian M. Haematogenous acute and subacute paediatric osteomyelitis: a systematic review of the literature. J Bone Joint Surg Br. 2012 May;94(5):584-95. doi: 10.1302/0301-620X.94B5.28523
11. Unkila-Kallio L, Kallio MJ, Eskola J, Peltola H. Serum C-reactive protein, erythrocyte sedimentation rate, and white blood cell count in acute hematogenous osteomyelitis of children. Pediatrics. 1994 Jan;93(1):59-62.
12. Conrad DA. Acute hematogenous osteomyelitis. Pediatr Rev. 2010 Nov;31(11):464-71. doi: 10.1542/pir.31-11-464
13. Gornitzky AL, Kim AE, O'Donnell JM, Swarup I. Diagnosis and Management of Osteomyelitis in Children: A Critical Analysis Review. JBJS Rev. 2020 Jun;8(6):e1900202. doi: 10.2106/JBJS.RVW.19.00202