Deep venous thrombosis in children with musculoskeletal infections: the clinical evidence
| Autor: | Athanassios Chatzimichael, Eleni Plessa, Evridiki K. Vouloumanou, Lambros Michailidis, Elpis Mantadakis, Matthew E. Falagas |
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| Rok vydání: | 2012 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Adolescent Embolism medicine.disease_cause Internal medicine medicine Humans cardiovascular diseases Child Intensive care medicine Prospective cohort study Children Venous Thrombosis Respiratory distress business.industry Osteomyelitis Incidence (epidemiology) Infant Thrombosis Retrospective cohort study General Medicine Staphylococcal Infections medicine.disease Methicillin-resistant Staphylococcus aureus Venous thrombosis Infectious Diseases Child Preschool Complication business |
| Zdroj: | International Journal of Infectious Diseases. 16:e236-e243 |
| ISSN: | 1201-9712 |
| DOI: | 10.1016/j.ijid.2011.12.012 |
| Popis: | Summary Background Clinical manifestations of deep venous thrombosis (DVT) tend to overlap with those of deep-seated musculoskeletal infections (MSIs). Consequently, the incidence of DVT as a complication of MSI may be underestimated. The objective of this study was to evaluate the incidence, clinical features, and outcomes of MSI-related DVT in children. Methods We systematically reviewed relevant studies retrieved from PubMed and Scopus databases. Results Overall, 93 children with MSIs who developed DVT were identified from 28 retrospective studies. The majority were boys. Osteomyelitis was the most frequent MSI (69/74, 93%). Staphylococcus aureus was the predominant pathogen (83/93, 89%); 61% of these isolates were methicillin-resistant S. aureus (MRSA). Pulmonary involvement, presumably due to septic emboli, was observed in 65% of the included children. Four children died due to multiple organ failure and two due to respiratory distress. In two of the three studies providing comparative data, MRSA infections were observed significantly more frequently in children who developed DVT compared to those who did not. Yet, the respective differences observed for methicillin-susceptible S. aureus (MSSA) infections were non-significant in these three studies. Conclusions Despite the inclusion of many case reports and the retrospective design of the evaluated studies, our findings suggest that boys seem to be more frequently affected by MSIs complicated by DVT. Moreover, MRSA seems to be more frequently associated with DVT compared to MSSA. Pulmonary involvement appears to be a frequent complication. Prospective studies are needed in order to further clarify this issue. |
| Databáze: | OpenAIRE |
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