TITLE:
Septic Chronic Multifocal Osteomyelitis in Children: A Challenging Presentation of Osteomylitis in a Low Income Country
AUTHORS:
S. A. Kissou, P. W. H. Dakouré, J. M. Somé, M. Soulama, M. Diallo
KEYWORDS:
Bacterial, Children, Hematogen, Multifocal, Osteomyelitis
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.8 No.6,
June
4,
2018
ABSTRACT: Background: The aim of this study was to describe the clinical, biological and x-ray
presentation of Septic Chronic Multifocal Osteomyelitis (SCMO) and discuss the
therapeutic difficulties of this pathology in an African Sub-Saharan teaching hospital. Patients and Methods: A
retrospective study was conducted in the Orthopedics and Trauma department of
the university teaching hospital of Bobo-Dioulasso (Burkina Faso). Over a
period of two years, we selected
all cases of chronic osteomyelitis. We studied the epidemiological, diagnostic and therapeutic aspects of SCMO
cases. Results: Eleven cases of SCMO were identified. The mean age of
the patients was 11.8 years and the sex ratio was 1.75. There were 7 rural
patients. The mean time to visit the hospital was 158 days. The most common
reasons for consultation were pain (10 cases), swelling (9 cases), and fever (7
cases). Two were sickle cell patients. The most affected bones were the femur
(10 cases), the tibia (9 cases) and the fibula (6 cases). The most frequent
specific radiological lesions were sequestra (6 cases) followed by pandiaphysitis. Staphylococcus aureus was the
most common aetiology. Treatment combined antibiotherapy and surgery (sequestrectomy and/or bone curettage and/or
fistulectomy). Hip dislocations, pathological
fractures and bone defect complicated the course of this disease. The therapeutic results was good in 3 patients and bad in 5 patients; the
other 3 patients were lost to follow-up. Conclusion: Septic chronic
multifocal osteomyelitis is a rare but formidable form of osteomyelitis in
children. Therapeutic outcomes are often poor in hospitals with limited
resources. The best strategy is prevention through early diagnosis and
aggressive treatment of acute osteomyelitis.