Osteomyelitis and Thrombosis in a Newborn with Group A Streptococcus Infection
Neonatal osteomyelitis (OM), although exceptionally rare, has been linked to detrimental sequel, as diagnosis in the early stages is challenging and any delay in treatment can lead to disturbance in skeletal growth. In pediatric OM the most commonly grown bacteria is Staphylococcus aureus followed b...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Karolinum Press
2023-09-01
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| Series: | Prague Medical Report |
| Online Access: | https://pmr.lf1.cuni.cz/124/3/0293/ |
| _version_ | 1827806652875669504 |
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| author | Georgios Mitsiakos Dimitra Gialamprinou Christos Tsakalidis Evgenia Babatseva Maria Lithoxopoulou Elisavet Diamanti |
| author_facet | Georgios Mitsiakos Dimitra Gialamprinou Christos Tsakalidis Evgenia Babatseva Maria Lithoxopoulou Elisavet Diamanti |
| author_sort | Georgios Mitsiakos |
| collection | DOAJ |
| description | Neonatal osteomyelitis (OM), although exceptionally rare, has been linked to detrimental sequel, as diagnosis in the early stages is challenging and any delay in treatment can lead to disturbance in skeletal growth. In pediatric OM the most commonly grown bacteria is Staphylococcus aureus followed by group A Streptococcus (GAS). Notwithstanding, sepsis-induced coagulopathy is a well-known entity in children and adults, still sepsis-associated thrombosis is sparsely observed. we present a case of a newborn with GAS associated OM and thrombosis. A term neonate on the 11th day of life was referred to our NICU due to right (R) lower limb edema, cyanosis and core temperature up to 39 °C. Late onset sepsis was suspected and started on vancomycin and amikacin. A colour Doppler scan showed thrombosis of the R common femoral vein. The neonate started on iv unfractionated heparin. Ampicillin was added given positive for GAS blood culture. An MRI on the 5th day of admission, showed evidence of thrombosis resolution. On the 14th day of admission, a bone Tc99 scan showed evidence of OM of R femur. Antibiotic treatment switched to amoxicillin per os. The management was restricted to anticoagulant therapy with low molecular weight heparin for 3 months and antibiotic therapy for 6 months without surgery intervention and the patient recovered and discharged at 42 days of age. Early diagnosis and treatment of neonatal osteomyelitis can prevent bone destruction. Sepsis-associated thrombosis is barely observed during osteomyelitis, yet it should be considered as an emerged case requiring prompt treatment. |
| first_indexed | 2024-03-11T21:45:06Z |
| format | Article |
| id | doaj.art-f154e6bfe7fc443aa3a5ef42ec492d83 |
| institution | Directory Open Access Journal |
| issn | 1214-6994 2336-2936 |
| language | English |
| last_indexed | 2024-03-11T21:45:06Z |
| publishDate | 2023-09-01 |
| publisher | Karolinum Press |
| record_format | Article |
| series | Prague Medical Report |
| spelling | doaj.art-f154e6bfe7fc443aa3a5ef42ec492d832023-09-26T10:59:12ZengKarolinum PressPrague Medical Report1214-69942336-29362023-09-01124329330010.14712/23362936.2023.23Osteomyelitis and Thrombosis in a Newborn with Group A Streptococcus InfectionGeorgios MitsiakosDimitra GialamprinouChristos TsakalidisEvgenia BabatsevaMaria LithoxopoulouElisavet DiamantiNeonatal osteomyelitis (OM), although exceptionally rare, has been linked to detrimental sequel, as diagnosis in the early stages is challenging and any delay in treatment can lead to disturbance in skeletal growth. In pediatric OM the most commonly grown bacteria is Staphylococcus aureus followed by group A Streptococcus (GAS). Notwithstanding, sepsis-induced coagulopathy is a well-known entity in children and adults, still sepsis-associated thrombosis is sparsely observed. we present a case of a newborn with GAS associated OM and thrombosis. A term neonate on the 11th day of life was referred to our NICU due to right (R) lower limb edema, cyanosis and core temperature up to 39 °C. Late onset sepsis was suspected and started on vancomycin and amikacin. A colour Doppler scan showed thrombosis of the R common femoral vein. The neonate started on iv unfractionated heparin. Ampicillin was added given positive for GAS blood culture. An MRI on the 5th day of admission, showed evidence of thrombosis resolution. On the 14th day of admission, a bone Tc99 scan showed evidence of OM of R femur. Antibiotic treatment switched to amoxicillin per os. The management was restricted to anticoagulant therapy with low molecular weight heparin for 3 months and antibiotic therapy for 6 months without surgery intervention and the patient recovered and discharged at 42 days of age. Early diagnosis and treatment of neonatal osteomyelitis can prevent bone destruction. Sepsis-associated thrombosis is barely observed during osteomyelitis, yet it should be considered as an emerged case requiring prompt treatment.https://pmr.lf1.cuni.cz/124/3/0293/ |
| spellingShingle | Georgios Mitsiakos Dimitra Gialamprinou Christos Tsakalidis Evgenia Babatseva Maria Lithoxopoulou Elisavet Diamanti Osteomyelitis and Thrombosis in a Newborn with Group A Streptococcus Infection Prague Medical Report |
| title | Osteomyelitis and Thrombosis in a Newborn with Group A Streptococcus Infection |
| title_full | Osteomyelitis and Thrombosis in a Newborn with Group A Streptococcus Infection |
| title_fullStr | Osteomyelitis and Thrombosis in a Newborn with Group A Streptococcus Infection |
| title_full_unstemmed | Osteomyelitis and Thrombosis in a Newborn with Group A Streptococcus Infection |
| title_short | Osteomyelitis and Thrombosis in a Newborn with Group A Streptococcus Infection |
| title_sort | osteomyelitis and thrombosis in a newborn with group a streptococcus infection |
| url | https://pmr.lf1.cuni.cz/124/3/0293/ |
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