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How to overcome osteomyelitis in a child?


What causes osteomyelitis in children? Forms of the disease and methods of their treatment. Symptoms of acute and chronic, hematogenous and traumatic osteomyelitis

Osteomyelitis - An infectious disease affecting the bone, periosteum and bone marrow, accompanied by suppuration and inflammation, and in severe necrosis.

Causes and types of pathology

How to overcome osteomyelitis in a child?The disease develops when microbes enter the bone through the affected area (traumatic form) or into the blood (hematogenous form).

In the overwhelming majority of the disease provokeStaphylococcus, but sometimes it's pneumococci and streptococci. In rare cases, the pathogen are microscopic fungi, Escherichia coli, Proteus and other pathogenic microorganisms.

Traumatic osteomyelitis, as one can judge fromTitle, arises from injuries, for example, after an open fracture, a gunshot wound, etc. Hematogenous osteomyelitis in adults and children is the result of a congenital or acquired internal infection. Most often this form of the disease is diagnosed in newborns and older children.

It is worth noting that they are most often affectedBoys. Infection in the blood is detected after an abscess, purulent sore throat, furuncles, tonsillitis, carious teeth and other infectious pathologies. Purulent lesion is localized not only on the bone, but also in the bone marrow. It leads to irreversible destructive changes.

Each type of disease has a form - maybeChronic or acute. The latter is most often observed with the development of the inflammatory process, that is, at the very beginning. In the absence of adequate treatment, it becomes chronic.

Clinical picture

Acute hematogenous osteomyelitis is observed inChildren for no more than 4 weeks. The complexity of the diagnosis lies in the fact that it is almost impossible to detect it earlier than 14 days after the onset.

Symptoms include:

  • Aching in the injured limb, arising spontaneously. In the future, it becomes sharp, bursting or boring, prevents normal movements;
  • Increased body temperature;
  • General poor state of health, unclear consciousness, nausea and vomiting, loss of appetite;
  • Lowering blood pressure, paleness and dryness of the skin, mucous membranes become bluish;
  • There is pain in palpation of the liver, spleen. The organs are enlarged;
  • The struck place swells and blushes, veins bulge, increase Regional lymph nodes;
  • The level of neutrophils, leukocytes, the level of ESR in the blood increases.

Symptoms of osteomyelitis develop in children very quickly, literally in 1-2 days.

How to overcome osteomyelitis in a child?If the timely does not start treatment, thenAn intermuscular phlegmon is formed. Purulent inflammation is affected by the nearest cells. At this time, a person's condition may improve slightly, but the need for a surgical intervention is still present. If the treatment does not begin, then there is a purulent arthritis and even sepsis - the infection of blood.

Symptoms of traumatic form do not differ from hematogenous. The only nuance - the presence of an open trauma allows you to observe the development of pathology.

In the absence of treatment or in the case ofInsufficient performance, the acute form of the disease becomes chronic. The latter develops within 2-3 months after the lesion and is characterized by necrosis of the affected tissue.

Chronic osteomyelitis is characterized in childrenTwo stages of the current: rest and exacerbation. They alternate with each other with different intensity, which is explained by the individual characteristics of the organism.

Symptoms of chronic form of hematogenous and traumatic osteomyelitis:

  • The affected area hurts, but swelling subsides. The general well-being of a person is improving. The temperature decreases;
  • The focus of inflammation is covered with a gray bloom. With traumatic form in the presence of an open wound, pus comes out of it;
  • There is a destruction of bone tissues, deformation of the joint;
  • There may be muscle atrophy. The prolonged course of the chronic form of the disease sometimes leads to a shortening of the diseased limb;
  • The metabolism is broken, which leads to the failure of organs.

Diagnosis of the chronic form of the disease includes X-ray and laboratory studies. They start it when the treatment of the acute course of the disease did not give tangible results.

Osteomyelitis in children

Approximately 90% of cases in children diagnosed with acute hematogenous osteomyelitis. The disease first affects the bone marrow, and then gets to the periosteum.

The peculiarity of this pathology is that itDifficult to diagnose at an early age. The smaller the child, the more difficult it is for doctors to diagnose. Very often, the only symptom of pathology in children under one year of age is restlessness and immobility of the limb.

Older children show the same signs as adults.

Osteomyelitis in children, as a rule, occurs in one of 3 forms:

  • Local - the easiest. It is characterized by an increased body temperature, moderate intoxication, and a satisfactory state of the child. The patient goes on the amendment after opening the abscess;
  • The septic-piecemic form is observed in almost 50%Of cases. The body temperature rises considerably, the child feels bad, it makes him vomit, vomiting can occur, headaches are observed. The affected limb swells, it hurts badly, blushes;
  • Toxic - a very rare form, occursIn about 2% of patients. In this situation, the body temperature falls along with the arterial pressure. Very often the disease ends in a lethal outcome.

Children, in view of the characteristics of the body, very hardEndure this ailment. When the parents noticed a mild nausea, a headache, the child complains of the painfulness of the limb, which is red and swollen, then you should immediately consult a doctor. The doctor, based on the results of X-rays, laboratory tests and ultrasound, will be able to confirm or disprove the alleged diagnosis.

Treatment of osteomyelitis in children by different methods

Conservative therapy is conducted in threeDirections. First, the infection of the pathogen is removed from the body. Antibiotics proved to be very successful in this case. Widely used: gentamicin, fuzidin, lincomycin, kefzol.

Other types of drugs in this range, includingPenicillin, are ineffective. In addition, doctors prescribe a powerful therapy to eliminate intoxication of the body. The complex of measures includes plasma transfusion, hemosorption, hyperbaric oxygenation.

How to overcome osteomyelitis in a child?The local treatment of the affected tissues of the body is mandatory. In this case, resort to physiotherapy procedures, and also impose a plaster longlet on the diseased limb.

It does not do without increasing the body's resistance to infections. A sick child should drink vitamins and various stimulants of the immune system.

Treatment of osteomyelitis can be conductedsurgically. At an early stage of the disease, bone trephination and drainage are often performed. If a phlegmon was formed, the operation involves cleansing from pus, eliminating fistulas, and sometimes removing the affected area.

Osteomyelitis in childhood is a great danger, so do not neglect treatment.

Parents should remember: The earlier the diagnosis is made, the better the prognosis and the more effective the result of therapy. If you do not turn to a specialist in time, the consequences of the pathology will be negative, up to a lethal outcome.

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