Recently, children are often diagnosed with a disease such as osteomyelitis. This is a purulent-necrotic process of an infectious nature that develops in the bones, surrounding soft tissues, and the bone marrow. This pathology is caused by bacteria that produce pus. If this disease becomes chronic, then there is a high probability of bone deformity of the unformed skeleton of the child.
Osteomyelitis in children most often affects the lower leg, thigh, jaw joints, humerus, vertebrae. To protect the baby from the onset of the adverse effects of this disease, it is necessary to limit the range of factors that cause such a pathology.
Causes of occurrence
Boys are more prone to this disease than girls. This is due to the fact that they are much more mobile. In addition, odontogenic osteomyelitis in children also occurs mainly in boys, since the causeits development are injuries of the jaw skeleton, which can be obtained in fights or during falls.
Quite often the cause of the disease in children are such foci of purulent infection as impetigo, otitis media, pyelonephritis, boils, burns, wounds. Also, abscesses, dental caries, purulent tonsillitis, tonsillitis lead to the development of osteomyelitis.
After entering the body through lesions in the skin, mucous membrane or lymphoid pharyngeal ring, the infection begins to spread through the circulatory system. Most often, the causative agent of osteomyelitis is the bacteria Staphylococcus aureus, which is found in 80% of cases. In the remaining 20% of patients, pathology is caused by streptococci, E. coli, salmonella, Pfeiffer's bacillus. The bacterium enters the body of infants through the umbilical wound.
Not in all cases, the bone is the focus of inflammation. The infection can spread to it from surrounding organs or soft tissues. The reverse situation is also quite possible, when first the bone marrow is damaged, and only then the tissues adjacent to it.
Symptoms of disease
This pathology can manifest itself in different ways depending on the age of the child, his immunity and the affected bone area. In newborns and children a little older, the disease affects their general well-being. The child becomes lethargic, he has nervous anxiety, appetite disappears, high temperature rises, pallor appears. Often pathologic althe condition is accompanied by diarrhea and vomiting.
If you watch a child, you can see that he begins to take care of his limb, tries not to touch it or move it. The skin of the affected joint is often reddened. After a few days, redness and swelling begin to increase. If you do not immediately begin treatment, purulent metastases will occur throughout the body.
Acute hematogenous osteomyelitis in older children is manifested in a more pronounced form. The development of inflammation is much slower, and redness and swelling begin to appear only a week after the onset of the disease. If treatment is not started in a timely manner, intermuscular phlegmon may occur, which means that the inflammatory process gradually spreads to the surrounding soft tissues. In this case, surgical intervention is inevitable. With intermuscular phlegmon, an improvement in the child's condition may be observed at first, but it is deceptive. Osteomyelitis in children can cause such formidable complications as purulent arthritis and sepsis.
The acute form of the disease in children after a while becomes chronic, the lack of treatment of which leads to death. Therefore, it is so important to diagnose this pathology in a timely manner and begin its treatment.
Features of odontogenic osteomyelitis
This type of pathology has its own characteristics. From the gums and canals of the teeth, pus begins to stand out, and the soft tissues of the face swell. The skin and mucous membranes are pale anddry, high temperature rises, chills and general weakness appear. In young children, convulsions, vomiting, and indigestion are noted. This indicates that the central nervous system begins to become irritated, as severe intoxication of the body develops. Odontogenic osteomyelitis of the jaw in children is of a protracted nature.
Chronic features
This form of pathology is primary and secondary. The latter is characterized by remissions and exacerbations, alternating with each other. During remission, the child does not complain about anything, but when an exacerbation begins, an increase in temperature is observed, pain appears on palpation. It is possible to open a fistula with the formation of pus. Such periods can last for years, and the kidneys, liver and heart are affected.
Chronic osteomyelitis in children of the primary type proceeds without an exacerbation phase, and the onset of the disease has blurred symptoms. Minor pain sensations do not have a clear localization. Most often, parents bring their children to the hospital only when the pain increases or severe symptoms appear.
Diagnosis
It is very important to correctly diagnose this disease, as its symptoms strongly resemble rheumatism, purulent arthritis, Ewing's sarcoma.
At the very beginning of its development, osteomyelitis of the bone in children has symptoms that can cause a doctor to suspect the formation of a malignantinfections. Only a correct diagnosis contributes to competent treatment, which guarantees a successful prognosis.
Treatment of disease
If a pathology such as osteomyelitis (children) has arisen, treatment should be carried out with the participation of a pediatrician, radiologist and other specialists. Most often, antibiotics are prescribed for this and surgery is performed.
Antibiotics should be used as early as possible. First, a loading dose of these drugs is given to the child in order to stop the inflammation. Most often, drugs of the penicillin group are prescribed for these purposes. Antibiotics should be taken for a long time, sometimes the course of treatment can last three months. The dose must be reduced gradually. At the same time, the child should be given drugs for thrush, because antibiotics destroy the microflora. Sometimes surgery may be required. In this case, the abscess is opened, the pus is removed and the canal is washed. The operation is fairly quick with the use of local anesthesia. Doctors sometimes put in a drain to remove fluid.
The main treatment for odontogenic osteomyelitis is surgery, which involves the removal of the tooth that is the source of the infection. Under general anesthesia, subperiosteal abscesses are opened. Carry out sowing of pus to determine the sensitivity of microflora to antibiotics. During surgery, the wound is drained, after which detoxification therapy, antihistamines, antibiotics, calcium preparations, vitamins andnonspecific immunomodulators. The child should be given to drink as much water as possible and feed him plant and dairy foods.
Complications
Osteomyelitis in children can cause various complications. These could be:
- bone defects;
- arthritis of limbs;
- musculoskeletal system is injured as a result of spinal cord pinching;
- if the disease has affected the hip joint or children's legs, in advanced cases, complete immobilization occurs;
- joint instability occurs;
- impaired bone growth;
- secondary chronic osteomyelitis begins to develop, which subsequently leads to a violation of posture;
- destructive dislocation occurs;
- Osteomyelitis of the upper jaw, which is often diagnosed in boys, causes the formation of meningitis, which entails changes throughout the body.
Conclusion
Despite the fact that osteomyelitis in children causes quite serious complications, modern medicine is able to successfully treat this formidable disease, guaranteeing the most favorable prognosis. According to statistics, deaths are decreasing every year. Parents should be more attentive to the he alth of their children, ensure that injuries and wounds do not get infected, and consult a doctor in a timely manner.
