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Boletín Médico del Hospital Infantil de México

Boletín Médico del Hospital Infantil de México
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2008, Number 1

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Bol Med Hosp Infant Mex 2008; 65 (1)

Pseudomonas aeruginosa-associated osteomyelitis of the patella and septic arthritis of the knee

Chávez-López MA, Cid-Guerrero D, Martínez-Medina L, Muñoz-Fernández L
Full text How to cite this article

Language: Spanish
References: 6
Page: 32-35
PDF size: 204.14 Kb.


Key words:

Osteomyelitis, Pseudomonas aeruginosa, septic arthritis, knee.

ABSTRACT

Introduction. Osteomyelitis of the patella is an infrequent infection that predominantly affects children. The most frequent microorganism is Staphylococcus aureus. Diagnosis should be considered in patients with pain and swelling around the patella, cellulitis, prepatellar bursitis (septic or not), and in patients with septic arthritis with no response to the standard treatment.
Case report. We report the case of a 14-year-old male patient with type 1 diabetes mellitus with pain and swelling of the left knee after being injured with a sharp metallic object. No response was obtained with oral antibiotics and anti-inflammatory drugs. Surgery, gammagraphy, and musculoskeletal ultrasound, together with the histology, confirmed septic arthritis of the knee and osteomyelitis of the patella due to Pseudomonas aeruginosa. Treatment with ceftazidime and subsequent ciprofloxacin resulted in total remission of symptoms.
Conclusion. A high level of suspicion and an exhaustive approach are required for definitive diagnosis of osteomyelitis of the patella, associated or not with septic arthritis.


REFERENCES

  1. Evans DK. Osteomyelitis of the patella. J Bone Joint Surg. 1962; 44B: 319-23.

  2. Roy DR. Osteomyelitis of the patella. Clin Orthop Relat Res. 2001; 389: 30-4.

  3. García-Porrúa C, González-Gay MA, Ibañez D, García-Pais MJ. The clinical spectrum of severe septic bursitis in northwestern Spain: a 10 years study. J Rheumatol. 1999; 26: 663-7.

  4. Mund DJ, Meisel AD. Pseudomonas osteomyelitis of patella. N Y State J Med. 1981; 81: 213-4.

  5. Roy DR, Greene WB, Gamble JG. Osteomyelitis of the patella in children. J Pediatr Orthop. 1991; 11: 364-6.

  6. Pawar S, Taj M, Gera R, Kumar A. Osteomyelitis of patella: a diagnostic dilemma. Int Pediatr. 2001; 16: 232-4.




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Bol Med Hosp Infant Mex. 2008;65