medigraphic.com
SPANISH

MediSur

ISSN 1727-897X (Electronic)
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2022, Number 4

<< Back Next >>

Medisur 2022; 20 (4)

Chronic osteomyelitis as evidence of a source of uncontrolled sepsis. A case report

Uriarte MAE, Capote PJL, Requeiro MJJ, Kauteks PLL
Full text How to cite this article

Language: Spanish
References: 18
Page: 760-766
PDF size: 193.54 Kb.


Key words:

osteomyelitis, sepsis, case reports.

ABSTRACT

Sepsis and septic shock are major health problems that affect millions of people worldwide and have a high lethality. The infection source control is one of the fundamental aspects to achieve success in treatment. Once sepsis is suspected as a syndrome, all tests should be performed to identify the primary site of origin and the necessary specialist teams should be used. The objective of this work is to transmit the experiences derived from the care of an infant whose diagnosis of septic shock was made retrospectively when chronic osteomyelitis of the distal end of the right femur was discovered as a primary source of undiagnosed infection. The patient was admitted to the pediatric intensive care unit with multi-organ dysfunction. The diagnosis initially focused on acute viral myocarditis, but four weeks later osteomyelitis was diagnosed with chronicity criteria. The retrospective analysis ruled out the previous diagnosis and suggested acute osteomyelitis as the cause for septic shock, a clinical picture that began in a hidden way, but which almost compromised the patient's life. In the presence of a suspicious case of sepsis, the presence of a source of infection should be exhaustively searched. Given its frequency, acute hematogenous osteomyelitis should be taken into account.


REFERENCES

  1. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-10.

  2. Allegranzi B, Reinhart K. Incidence and mortality of hospital- and ICU-treated sepsis: results from an updated and expanded systematic review and meta-analysis. Intensive Care Med. 2020;46(8):1552-1562.

  3. Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, Schlapbach LJ, Reinhart K, Kissoon N. The global burden of paediatric and neonatal sepsis: a systematic review. Lancet Respir Med. 2018;6(3):223-230.

  4. Sánchez Díaz JI, de Carlos Vicente JC, Gil Antón J. Diagnóstico y tratamiento del shock séptico y de la sepsis asociada a disfunción orgánica. Protoc diagn ter pediatr. 2021;1:585-610.

  5. Weiss SL, Pomerantz WJ. Septic shock in children: Rapid recognition and initial resuscitation (first hour)[Internet]. Alphen aan den Rijn: Uptodate; 2020 [citado: 06/07/2020]. Disponible en: Disponible en: https://www.uptodate.com/contents/septic-shock-in-children-rapidrecognition-and-initial-resuscitation-first-hou 5. .

  6. Weiss SL, Peters MJ, Alhazzani W, Flori HR, Inwald DP, Carrol ED, et al. Surviving Sepsis Campaign International Guidelines for the management of septic shock and sepsis associated organ dysfunction in children. Pediatr Crit Care Med. 2020;21(2):e52-e106. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32032273/6. .

  7. Cardoso Armas R, Uriarte Méndez A. Sepsis en edad pediátrica. Revista Cubana de Medicina Intensiva y Emergencias[Internet]. 2021 [citado 14 Mar 2022];20(2):e806. Disponible en: http://www.revmie.sld.cu/index.php/mie/article/view/8067. .

  8. McNeil JC. Acute Hematogenous Osteomyelitis in Children: Clinical Presentation and Management. Infect Drug Resist. 2020;13:4459-73.

  9. Offiah AC. Acute osteomyelitis, septic arthritis and discitis: differences between neonates and older children. Eur J Radiol. 2006;60(2):221-32.

  10. Thakolkaran N, Shetty AK. Acute hematogenous osteomyelitis in children. Ochsner Journal. 2019;19(2):116-22.

  11. Jaramillo D, Dormans JP, Delgado J, Laor T, St Geme JW. Hematogenous Osteomyelitis in Infants and Children: Imaging of a Changing Disease. Radiology. 2017;283(3):629-643.

  12. Dienst T, Lewin M, Genin C, Maton P. Acute neonatal osteomyelitis, an incidental life-changing diagnosis. Rev Med Liege. 2020;75(12):763-6.

  13. Rueda Mejía AM, Riera Soler L, Oliva Brañas EO, Joaqui López N, Pons Diviu N, Diez Izquierdo A. Evaluación de las imágenes diagnósticas en la osteomielitis en niños[Internet]. Málaga: Seram; 2018[citado 17/02/2022. Disponible en: Disponible en: https://piper.espacio-seram.com/index.php/seram/article/download/1980/994/1974 13.

  14. Méndez Brenes M, Solórzano Gómez N, Matamoros Orozco D. Osteomielitis aguda: clasificación, fisiopatología y diagnóstico. Revista Médica Sinergia. 2020;5(8):e554.

  15. Gavelli F, Castello LM, Avanzi GC. Management of sepsis and septic shock in the emergency department. Intern Emerg Med. 2021;16(6):1649-61.

  16. Gauer R, Forbes D, Boyer N. Sepsis: Diagnosis and Management. Am Fam Physician. 2020;101(7):409-18.

  17. Timsit JF, Ruppé E, Barbier F, Tabah A, Bassetti M. Bloodstream infections in critically ill patients: an expert statement. Intensive Care Med. 2020;46(2):266-284.

  18. Garcia PCR, Tonial CT, Piva JP. Septic shock in pediatrics: the state-of-the-art. J Pediatr (Rio J). 2020;96 Suppl 1:87-98.




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Medisur. 2022;20