Oddelek za pediatrijo Splošna bolnišnica Izola Polje 40, 6310 Izola, Slovenija
Klinika za infekcijske bolezni in vročinska stanja, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija
Klinika za infekcijske bolezni in vročinska stanja, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija Pediatrična klinika Ljubljana, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija Katedra za infekcijske bolezni in epidemiologijo, Medicinska fakulteta, Univerza v Ljubljani, Ljubljana, Slovenija
In a child with fever, limping, refusal to use an extremity or experiencing limb pain, musculoskeletal infection should always be considered. Two frequent and important clinical conditions are septic arthritis and osteomyelitis. In more rare cases, the cause can be a muscle infection, pyogenic myositis, or infection of the fasciae (necrotizing fasciitis). All these clinical conditions can, in case of inadequate or delayed treatment, result in lifelong sequelae and, if left untreated, can even progress to sepsis, shock and death. Viral pathogens or the Borrelia burgdorferi spirochete can also be a cause of arthritis, but in the latter, the course of the disease is usually less acute and slower. In the article, we present two of the most common paediatric infections of the musculoskeletal system -septic arthritis and osteomyelitis of the limbs. when an osteoarticular infection is suspected in children, a team approach of the primary care paediatrician, paediatric infectious diseases specialist, skeletal radiologist, clinical microbiologist and orthopaedic surgeon is necessary. Diagnosis should be made as soon as possible, followed by appropriate antibiotic treatment. Sometimes, a surgical procedure is needed. The prognosis of osteoarticular infections in children, if treated on time and adequately, is usually good. we also present two algorithms on management of septic arthritis and osteomyelitis in children.
Key words: septic arthritis, osteomyelitis, Staphylococcus aureus, Kingella kingae