Preview

Pediatric pharmacology

Advanced search

Late Neonatal Sepsis with Acute Haematogenous Osteomyelitis Foci: Clinical Case

https://doi.org/10.15690/pf.v17i4.2167

Abstract

Background. The incidence of sepsis among newborns ranges from 1–12 to 38 per 1,000 live births in the world according to scientific literature [1, 2]. The clinical case demonstrates the features of the newborn organism sensitivity and the therapeutic and diagnostic process difficulties.

Clinical case description. The boy was born on the 37th week of gestation, 1st of twins, with body weight 3330 g, height 51 cm, APGAR score 8/9 points. He was on breastfeeding. His condition has deteriorated rapidly on the 9th day of life. The condition was severe due to intoxication syndrome, necrotising enterocolitis (NEC) manifestation, further development of systemic inflammatory response syndrome and multiple organ dysfunction syndrome. Severe pain syndrome and movement restraint in limbs have appeared on the 20th day of life. X-ray imaging: NEC signs, multiple osteomyelitis foci in the limbs.

Conclusion. Modern adequate diagnosis and justified treatment tactics have led to positive outcome: child’s condition has improved, body weight has increased, pain syndrome has been managed, the volume of movements in the limbs has increased, inflammatory markers have stabilised. The child was discharged from hospital in satisfactory condition at the age of 2 months.

About the Authors

Marietta V. Manucharyan
Pirogov Russian National Research Medical University
Russian Federation
Moscow
Disclosure of interest: Authors confirmed the absence of a reportable conflict of interests.


Tatiana V. Turti
Pirogov Russian National Research Medical University; Research Institute of Pediatrics and Children’s Health in «Central Clinical Hospital of the Russian Academy of Sciences»; Research Institute for Healthcare and Medical Management of Moscow Health Department; G.N. Speransky Children’s Municipal Clinical Hospital № 9
Russian Federation
Moscow
Disclosure of interest: Authors confirmed the absence of a reportable conflict of interests.


Irina A. Belyaeva
Pirogov Russian National Research Medical University; Research Institute of Pediatrics and Children’s Health in «Central Clinical Hospital of the Russian Academy of Sciences»; Morozov Children’s City Clinical Hospital
Russian Federation
Moscow
Disclosure of interest: Authors confirmed the absence of a reportable conflict of interests.


Tatiana E. Privalova
Pirogov Russian National Research Medical University; Research Institute of Pediatrics and Children’s Health in «Central Clinical Hospital of the Russian Academy of Sciences»
Russian Federation
Moscow
Disclosure of interest: Authors confirmed the absence of a reportable conflict of interests.


Ludmila M. Makarova
G.N. Speransky Children’s Municipal Clinical Hospital № 9
Russian Federation
Moscow
Disclosure of interest: Authors confirmed the absence of a reportable conflict of interests.


Marina A. Ovsyannikova
G.N. Speransky Children’s Municipal Clinical Hospital № 9
Russian Federation
Moscow
Disclosure of interest:

Authors confirmed the absence of a reportable conflict of interests.



References

1. Tallur SS, Kasturi AV, Nadgir SD, et al. Clinico-bacteriological study of neonatal septicemia in Hubli. Indian J Pediatr. 2000;67(3):169–174. doi: 10.1007/BF02723654.

2. The Who Young Infants Study Group. Clinical prediction of serious bacterial infections in young infants in developing countries. Pediatr Infect Dis J. 1999;18(10 Suppl):S23–31.

3. Wu I, Tsai M, Lai M, et al. Incidence, clinical features, and implications on outcomes of neonatal late-onset sepsis with concurrent infectious focus. BMC Infect Dis. 2017;17(1):465. https://doi.org/10.1186/s12879-017-2574-7.

4. Cantey JB. Neonatal Infections: Pathophysiology, Diagnosis, and Management. Cham: Springer International Publishing; 2018. doi: 10.1007/978-3-319-90038-4.

5. Patel RM, Denning PW. Intestinal microbiota and its relationship with necrotizing enterocolitis. Pediatr Res. 2015;78(3):232–238. doi:10.1038/pr.2015.97.

6. Ono S, Fujimoto H, Kawamoto Y. Rare Full-Term Newborn Case of Rib Osteomyelitis with Suspected Preceding Fracture. AJP Rep. 2016;6(1):104–107. doi: 10.1055/s-0035-1570320.

7. Kawasaki T, Shime N, Straney L, et al. Paediatric sequential organ failure assessment score (pSOFA): a plea for the world-wide collaboration for consensus. Intensive Care Med. 2018;44(6):995–997. doi:10.1007/s00134-018-5188-7

8. Korsunskiy IA. Rannyaya diagnostika immunodefitsitnykh sostoyanii u detei: klinicheskie i laboratornye aspekty. [ abstract of dissertation]. Moscow; 2019. Доступно по: https://www.sechenov.ru/upload/medialibrary/5f1/Dissertatsiya-finalnaya.pdf. Ссылка активна на 16.07.2020.

9. Dong Y, Speer CP. Late-onset neonatal sepsis: recent developments. Archives of Disease in Childhood — Fetal and Neonatal Edition. 2015;100(3):F257–F263. doi: 10.1136/archdis-child-2014-306213.

10. Lakhundi S, Zhang K. Methicillin-Resistant Staphylococcus aureus: Molecular Characterization, Evolution, and Epidemiology. Clin Microbiol Rev. 2018;31(4):e00020–00018. doi:10.1128/CMR.00020-18.

11. Lambert D, Christensen R, Henry E, et al. Necrotizing enterocolitis in term neonates: data from a multihospital health-care system. J Perinatol. 2007;27(7):437–443. doi: 10.1038/sj.jp.7211738.

12. Gephart SM, McGrath JM, Effken JA, Halpern MD. Necrotizing enterocolitis risk: state of the science. Adv Neonatal Care. 2012;12(2):77–89. doi:10.1097/ANC.0b013e31824cee94.

13. Qian T, Zhang R, Zhu L, et al. [Analysis of Clinical Characteristics of Necrotizing Enterocolitis in Term Infants]. Zhonghua Yi Xue Za Zhi = National Medical Journal of China. 2016;96(22):1766–1772. doi:10.3760/cma.j.issn.0376-2491.2016.22.012.

14. Al Tawil K, Sumaily H, Ahmed IA, et al. Risk factors, characteristics and outcomes of necrotizing enterocolitis in late preterm and term infants. J Neonatal Perinatal Med. 2013;6(2):125–130. doi:10.3233/NPM-1365912.

15. Schlapbach LJ, Straney L, Bellomo R, et al. Prognostic accuracy of age-adapted SOFA, SIRS, PELOD-2, and qSOFA for in-hospital mortality among children with suspected infection admitted to the intensive care unit. Intensive Care Med. 2018;44(2):179–188. doi:10.1007/s00134-017-5021-8

16. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801–810. doi:10.1001/jama.2016.0287

17. Lekmanov AU, Mironov PI, Rudnov VA, Kulabukhov VV. Modern definitions and principles of intensive care of sepsis in children. Messenger of Anesthesiology and Resuscitation. 2018;15(4):61–69. doi: 10.21292/2078-5658-2018-15-4-61-69.

18. Matics TJ, Sanchez-Pinto LN. Adaptation and Validation of a Pediatric Sequential Organ Failure Assessment Score and Evaluation of the Sepsis-3 Definitions in Critically Ill Children. JAMA Pediatr. 2017;171(10):e172352. doi:10.1001/jamapediatrics.2017.2352.

19. Heida FH, Hulscher JB, Schurink M, et al. Bloodstream infections during the onset of necrotizing enterocolitis and their relation with the pro-inflammatory response, gut wall integrity and severity of disease in NEC. J Pediatr Surg. 2015;50(11):1837–1841. doi:10.1016/j.jpedsurg.2015.07.009.

20. Cole BK, Ilikj M, McCloskey CB, et al. Antibiotic resistance and molecular characterization of bacteremia Escherichia coli isolates from newborns in the United States. PLoS One. 2019;14(7):e0219352. doi: 10.1371/journal.pone.0219352.

21. Adams M, Bassler D. Practice variations and rates of late onset sepsis and necrotizing enterocolitis in very preterm born infants, a review. Transl Pediatr. 2019;8(3):212–226. doi:10.21037/tp.2019.07.02.

22. Tsybin AA, Mashkov AE, Weiss VA, et al. Gematogenous osteomyelitis in newborns (new technology experience). Journal of new medical technologies, eEdition. 2019;(1):40–47. doi: 10.24411/2075-4094-2019-16305.

23. Brady MT. Health care-associated infections in the neonatal intensive care unit. Am J Infect Control. 2005;33(5):268–275. doi:10.1016/j.ajic.2004.11.006.

24. Giannoni E, Agyeman PKA, Stocker M, et al. Neonatal Sepsis of Early Onset, and Hospital-Acquired and Community-Acquired Late Onset: A Prospective Population-Based Cohort Study. J Pediatr. 2018;201:106–114.e4. doi:10.1016/j.jpeds.2018.05.048.


Review

For citations:


Manucharyan M.V., Turti T.V., Belyaeva I.A., Privalova T.E., Makarova L.M., Ovsyannikova M.A. Late Neonatal Sepsis with Acute Haematogenous Osteomyelitis Foci: Clinical Case. Pediatric pharmacology. 2020;17(4):345-351. (In Russ.) https://doi.org/10.15690/pf.v17i4.2167

Views: 1454


ISSN 1727-5776 (Print)
ISSN 2500-3089 (Online)