6533b820fe1ef96bd1279910

RESEARCH PRODUCT

PULMONARY AND CARDIAC COMPLICATIONS OF STAPHYLOCOCCAL OSTEOMYELITIS

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Pulmonary complications of staph.osteomyelitis seem to be infrequent and are seldom related in wide reviews of this entity and in texts of infectious diseases.Cardiac complications are still more infrequently found.However our experience is far from this observation. We have found pneumonic interstitial infiltrates and/or asymptomatic pneumatoceles in about two thirds of children suffering from staph. osteomyelitis to whom we have taken a weekly chest radiograph while they were feverish.Severe forms are rare.Lately,however,we have treated 5 children with acute staph.osteomyelitis,aged 6 to 13,and whith severe pulmonary and cardiac complications.They had broad bone lesions which affected (1)left femur and tibia,(2)right femur,(3)right tibia,(4)left femur,(5)left femur and fibula.Pulmonary and cardiac complications were respectively (1)pneumatoceles,bilateral pleural effusion,pericardial effusion,(2)pneumonia and pulmonary haemorrhage, cardiomegaly,heart failure and death,(3)bilateral pneumatoceles,right pleural effusion,left pyopneumothorax,cardiomegaly and heart failure, (4)interstitial pneumonia,cardiomegaly and heart failure,(5)right pneumatoceles,cardiomegaly.In all of them a coagulase positive staphilococcus aureus was isolated from the bone lesion exudate,blood and/or pleural fluid,and in the pulmonary tissue of the child who died. We would like to emphasize the high frequency of pulmonary lesions, mainly asymptomatic and the possibility of severe pulmonary and cardiac complications during the course of haematogenous osteomyelitis despite antistaphylococcal drugs and surgical therapy.