OSTEOMYELITIS OF FEMUR IN A DRUG ADDICTED CHILD

  • Ilija Kirovski University Clinic of Pediatrics, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, R. of North Macedonia
  • Vesna Micevska University Clinic of Pediatrics, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, R. of North Macedonia
  • Aspazija Sofijanova University Clinic of Pediatrics, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, R. of North Macedonia
  • Sonja Bojadzieva University Clinic of Pediatrics, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, R. of North Macedonia
  • Silvana Naunova Timovska University Clinic of Pediatrics, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, R. of North Macedonia
  • Olivera Jordanova University Clinic of Pediatrics, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, R. of North Macedonia

Abstract

One of the serious complications related to intravenous drug use is osteomyelitis. We report a 13-year-old male child with a history of intravenous heroin abuse, who was admitted to the hospital complaining of abdominal pain and pain in the left leg. Anteroposterior roentgenogram and CT scan of the left thigh and femur, confirmed the diagnosis of osteomyelitis. Pus culture was positive for Staphylococcus aureus. Despite extensive antibiotic and anticoagulant therapy, the patient’s clinical status improved very slowly. Surgical procedure was not undertaken. Femoral osteomyelitis due to injection drug use in childhood is an extremely rare and uncommon condition. Intravenous drug abuse, late-onset treatment, and secondary bacterial infection can lead to complications which occurred in the case presented. It is an extremely difficult condition to treat and is a real challenge for physicians. The rapid response and participation of a multidisciplinary team of physicians is of particular importance.


Key words: antibiotics, children, femur, osteomyelitis, staphylococcus aureus.

References

1.Peltola H, Paakkonen M. Acute Osteomyelitis in Children. N Engl J Med 2014;370(4):352-60.
2.Riise OR, Kirkhus E, Handeland KS, Flato B, Reiseter T, Cvancarova M et al. Childhood osteomyelitis-incidence and differentiation from other acute onset musculoskeletal features in a population-based study. BMC Pediatr 2008;8:45. doi: 10.1186/1471-2431-8-45.
3.Dartnell J, Ramachandran M, Katchburian M. Haematogenous acute and subacute paediatric osteomyelitis: a systematic review of the literature. J Bone Joint
Surg Br 2012;94:584-95.
4.Gifford DB, Patzakis M, Ivler D, Swezey RL. Septic arthritis due to pseudomonas in heroin addicts. J Bone Joint Surg Am 1975;57:631-5.
5.Miskew D, Lorenz M, Pearson R, Pankovich A. Pseudomonas aeruginosa bone and joint infections in drug abusers. J Bone Joint Surg Am 1983;65:829-832.
6. Roca RP, Yoshikawa TT. Primary skeletal infections in heroin users: a clinical characterization, diagnosis and therapy. Clin Orthop Relat Res 1979;144:238-48.
7.Munoz-Fernandez S, Macia MA, Pantoja L, Cardenal A, Pena JM, Martin Mola E et al. Osteoarticular infection in intravenous drug abusers: influence of HIV infection and differences with non drug abusers. Ann Rheum Dis 1993;52:570-4.
8.Belzunegui J, Rodriguez-Arrondo F, Gonzalez C, Queiro R, Martinez de Bujo M, Intxausti JJ et al. Musculoskeletal infections in intravenous drug addicts: report of 34 cases with analysis of microbiological aspects and pathogenic mechanisms. Clin Exp Rheumatol 2000;18:383-6.
9.Delaney FT, Emma Stanley E, Bolster F. The needle and the damage done: musculoskeletal and vascular complications associated with injected drug use. Insights Imaging 2020;11(1):98. doi:10.1186/s13244-020-00903-5.
10.Hammond PJ, Macnicol MF. Osteomyelitis of the pelvis and proximal femur: diagnostic difficulties. J Pediatr Orthop B 2001;10(2):113-9.
11.Nakhoul M, Carine Richa C, Jreij A, Antoine Rached AA. Prevalence of hepatitis B and hepatitis C among intravenous drug abusers in the Lebanese population. J Infect Dev Ctries 2018;12(2.1):28S. doi: 10.3855/jidc.10076.
Published
2021-03-11
How to Cite
KIROVSKI, Ilija et al. OSTEOMYELITIS OF FEMUR IN A DRUG ADDICTED CHILD. Journal of Morphological Sciences, [S.l.], v. 4, n. 1, p. 46-49, mar. 2021. ISSN 2545-4706. Available at: <http://jms.mk/jms/article/view/189>. Date accessed: 17 june 2021.
Section
Articles