ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ TRẺ BỊ VIÊM XƯƠNG TUỶ TẠI TRUNG TÂM NHI KHOA, BỆNH VIỆN BẠCH MAI

Abstract

Objective: Describe the clinical and paraclinical characteristics of children with osteomyelitis. Evaluate treatment results and factors related to the disease such as medical history and injury. Subjects and methods: Prospective, descriptive, cross-sectional study conducted on 46 osteomyelitis patients, at the Pediatric Center, Bach Mai Hospital. Results: The ratio of boys/girls is 2,1:1. The average age is 11.3 years old. The most common clinical manifestations are pain (97.8%), swelling at the injury site (78.3%), and limited movement (80.4%). The tibia and femur are most commonly injured bones. The most common pathogen is Staphylococcus aureus. Tests that help confirm the diagnosis are leukocytosis (69.6%), increased CRP (59.1%), and diagnostic imaging (bone lesions appear on MRI earlier than X-ray). All children received antibiotic treatment. Parenteral antibiotics used according to the antibiogram are mainly Vancomycin, accounting for 76.1%. Linezolid (30.4%) is used when children have allergic symptoms (rash) after using Vancomycin. 02 cases received solely oral treatment. The remaining 44 patients received intravenous antibiotic therapy for an average of 24.7 days. The average length of hospital stay was 25.61 ± 12.63; at least 6 days and at most 62 days. 13 children had surgical intervention, accounting for 28.3%. Conclusion: Osteomyelitis often appears in boys with non-specific symptoms such as fever, pain, swelling and restricted mobility of the affected limb. Timely diagnosis is necessary to prevent complications and stop acute osteomyelitis from turning into chronic. Additional multicenter studies are required to examine geographical variations in the causative organism, therapy, and features of pediatric osteomyelitis in order to provide clinical practice guidelines.