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Pediatric Osteoarticular Infections
Anil K Agarwal, Aditya N Aggarwal
1:
Pediatric Osteoarticular Infections—Epidemiology
Introduction
Nontubercular Osteoarticular Infections
Acute Osteomyelitis
Septic Arthritis
Organisms
Risk Factors
Pyomyositis
Indian Scenario
Osteoarticular Tubercular Infections
Incidence
Coinfection with HIV
Indian Scenario
2:
Laboratory Diagnosis of Osteoarticular Infections in Children
Clinical Background
Collection of Specimens
Transport and Handling
Synovial Fluid Analysis
Gross Examination
Direct Microscopy
Gram Staining, Acid Fast Staining and Synovial Fluid Cultures
Synovial Fluid Biochemistry
Special Investigations
Histopathological Diagnosis
Blood Investigations
Bacterial Cultures
Surrogate Laboratory Markers
White Blood Cell Counts
Erythrocyte Sedimentation Rate and C-reactive Protein
Procalcitonin
Tissue
Molecular Diagnosis
Considerations in Diagnosis of Acute Hematogenous Osteomyelitis
Special Situations
Culture Negative Osteomyelitis
Osteoarticular Tuberculosis
Tuberculin Skin Test
Direct Microscopy
Mycobacterial Cultures
Synovial Fluid Biochemistry
Histopathological Diagnosis
Blood Investigations
Interferon Gamma Release Assays
Molecular Analysis
Algorithms for Laboratory Diagnosis
3:
Conservative Treatment of Acute Osteoarticular Infections
Introduction
Systemic Antibiotics and Local Aspiration
Other Medications
Local Splintage and Rehabilitation
Nutrition
Hydration
General Care
4:
Surgical Interventions in Osteoarticular Infection—Indications, Procedures and Postoperative Management
Acute Hematogenous Osteomyelitis
Acute Suppurative Arthritis
Chronic Osteomyelitis
Management Protocol of Chronic Osteomyelitis
Bone Defect Reconstruction Following Chronic Osteomyelitis in Children
5:
A Sick Child with Sepsis (Including Osteoarticular Infections): ICU Management
Introduction
Initial Assessment, Observation, Identification of Critically Sick Child and Triage
Danger Signs in Newborns and Young Infants
Stabilization of Critically Sick Child Including Management of Airway, Breathing and Circulation
Assess and Treat
Definitions of Pediatric Sepsis
Osteoarticular Infections as a Specific Cause of Neonatal Sepsis
Laboratory Investigations
Differential Diagnosis and Specific Treatment
Monitoring and Supportive Care
Supportive Care in Sick Child14
Parental Counseling
6:
Septic Arthritis in Children
Definition
Pathogenesis
Causative Organisms
Epidemiology
Clinical Manifestations
Diagnosis
Differential Diagnosis
Treatment
The Choice of Antibiotics
Duration of Treatment
Surgical Intervention
Supportive Treatment
Follow-up
Complications
7:
Sequelae of Septic Hip and its Reconstruction
Introduction
Pathophysiology
Natural History of the Septic Arthritis of Hip
Clinical Findings in Sequelae of Septic Hip
Classifications of Sequelae of Septic Hip in Children
Treatment
Femoropelvic Articulation Present (Choi types I, II, III, IVA)
Femoropelvic Articulation Not Present
8:
Acute Hematogenous Osteomyelitis
Definition
Pathogenesis
Classical Pathogenesis (Figs 8-1A and B)
Periosteal Hypothesis
Causative Organisms
Osteomyelitis Caused by MRSA: the “Aggressive” Osteomyelitis
Epidemiology
Clinical Manifestations
Diagnosis
Hematological Investigations
Imaging
Plain Radiographs
Ultrasonography
Bone Scans
Computed Tomography
Magnetic Resonance Imaging
Positron Emission Tomography
Differentiation between MRSA and MSSA Osteomyelitis in Children
Concomitant Hematogenous Osteomyelitis and Septic Arthritis
Differential Diagnosis of AHO (Table 8-4)
Treatment
The Choice of Antibiotics
Duration of Treatment
Surgical Intervention
Supportive Treatment
Follow-up
Complications
9:
Chronic Osteomyelitis
Definition
Pathogenesis
Causative Organisms
Epidemiology
Clinical Findings
Diagnosis
Imaging Modalities
Classification
Management
Clinical Decisions in the Management of Chronic Osteomyelitis
Debridement and Sequestrectomy
Presence of Physeal Damage
Antibiotic Prescription
Reconstruction of Soft Tissue and Osseous Defects
Complications
Prognosis
10:
Atypical Osteomyelitis and Other Musculoskeletal Infections
Introduction
Atypical Osteomyelitis
Mycobacterial Osteomyelitis
Atypical Tubercular Presentations
Nontubercular Mycobacterial Bone and Joint Infections
Clinical Presentation of Atypical Mycobacterial Infections
Histology
Imaging
Treatment
Culture Negative Osteomyelitis
Fungal Osteomyelitis
Viral Osteomyelitis
Helminthic Osteomyelitis
Salmonella Osteomyelitis
Treponemal Osteomyelitis
Garre's Sclerosing Osteomyelitis
Brodie's Abscess
Chronic Recurrent Multifocal Osteomyelitis
Plantar Puncture Wound
Spinal Osteomyelitis
Musculoskeletal Infections associated with HIV
Other Musculoskeletal Infections
Pyomyositis
Necrotizing Fasciitis
Human and Animal Bites
Osteomyelitis Following Open Injuries in Children
11:
Pediatric Hand Infections
Introduction
General Principles of Pediatric Hand Infections
Specific Infections
Cellulitis
Paronychia/Eponychia
Felon
Herpetic Whitlow
Flexor Tenosynovitis
Deep Fascial Space Infection
Special Situations
Septic Arthritis
Osteomyelitis
Fight Bites
Animal Bites
Tuberculosis
Summary
12:
Tuberculosis of Spine in Children
Introduction
Growth of Spine
Tuberculosis of Spine in Children: Onset of Deformity
Diagnosis
Treatment
Patients with Active Disease and no Clinical Kyphosis
Patients with Active Disease and Kyphosis
Correction of Kyphosis
Kyphosis Correction in Active Disease
Single Stage Transpedicular Approach
Single or Two-stage Anterior and Posterior Surgery
Single Stage Kyphosis Correction by Extrapleural Anterolateral Approach
Kyphosis Correction in Healed Lesion
Late Onset Paraplegia or Paraplegia with Healed Disease
Instrumentation in Children
13:
Tuberculosis of Hip in Children
Introduction
Historical Review
Pathogenesis
Establishing a Diagnosis
Clinico-radio-pathological Diagnosis
Clinical Presentation
Signs
Radiological Findings
Differential Diagnosis15
Management
Role of Antitubercular Drugs
Role of Surgery in Tubercular Hip in Children
Prognosis
14:
Drug-resistant Osteoarticular Tuberculosis and Coinfection with HIV
Introduction
Definitions
Epidemiology
When to Suspect
Laboratory Findings
Treatment
Antitubercular Drugs
Surgery
Nutritional Support and Treatment
Immunomodulation
Prognosis
Management of Children Exposed to MDR-TB Source (But not Developed Infection)
WHO Initiatives
HIV Coinfection
15:
Advances and Research in Pediatric Osteoarticular Infections
Nontubercular Infections
Introduction
Epidemiology
Laboratory Investigations
Imaging
Management Guidelines
Wound Care Options
Vaccination and Augmenting Host Response Against Staphylococcus aureus
Osteoarticular Tuberculosis
Introduction
Epidemiology
Diagnostic Modalities
Imaging
Antitubercular and Supportive Therapy
Surgical Intervention in Osteoarticular Tuberculosis
Immunology and Vaccination
Experimental Work
INDEX
TOC
Index
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