TITLE:
Therapeutic Aspects of Chronic Bone Infections and Management Challenges
AUTHORS:
Charles Diémé, Lamine Sarr, Alioune Badara Guèye, Ndeye Fatou Coulibaly, André Sané, Abdoulaye Ndiaye, Seydina Sèye
KEYWORDS:
Chronic Bone Infection; Management; Challenges
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.4 No.2,
February
7,
2014
ABSTRACT: This study aims to investigate
various aspects of the treatment of chronic bone infections and the challenges
in their management. The characterization of treatment of 73 patients with
chronic bone infection was reported. The four management challenges including
consultation delay, immune depression, extreme variety of
clinical manifestations and non-use of CT or MRI were discussed in this study.
We conducted a retrospective study at Aristide Le Dantec Hospital on 90 cases
of chronic bone infection in 73 patients. The mean duration of symptoms before
consultation was 36 months. More than half of the patients had a productive
fistula at the first consultation. Sickle cell anemia was found in 6 patients.
Multiple lesions were found in 10 patients; and long bones were affected in 90%
of cases. The bacterial culture was positive in 93.15%. Staphylococcus aureus
was the most isolated germ (68.35%). Seventy-two
out of seventy-three patients were operated on. The procedure depended on
anatomical and radiological lesions. Surgical treatment was associated with
antibiotherapy which was firstly probabilistic and secondarily adapted to the
results of bacterial culture. A favorable trend was found in 41 patients
(56.16%). 32 cases of adverse effects were noted (43.83%), and 27 patients had
recurrence after a favorable outcome. Several complications and sequelae were
observed demonstrating the tenacity of these chronic infections.