Demography and Impact of Initiation of Definitive Treatment in Osteoarticular Infections of Infants and Neonates

Abstract

Background: Osteoarticular infections in infants, such as osteomyelitis and septic arthritis, are a growing problem with a potential for not only systemic after-effects but also irreversible joint damage and limb deformity. Therefore, early treatment is necessary to reduce permanent damage/deformity. The purpose of this study is to find out the demography and impact of early initiation of definitive institutional management in osteoarticular infections. Materials and Methods: This study was conducted after approval by the institutional review board. All neonates and infants admitted between June 2019 and May 2021 with a clinical and laboratory diagnosis of osteoarticular infection were included in this study. Data for each patient were collected using the Hosp Gestor program. Patients having a history of pain, redness, swelling in joints associated with fever, and discharging sinus from bone were studied for unknown risk factors and atypical presentations. The impact of definitive management and sequelae were noted in all patients. Results: In this study, males were affected more than females. Osteoarticular infection of septic arthritis (53%) is the most common followed by osteomyelitis (43%) affecting predominantly the hip joint. In the majority of the cases, atypical risk factors like congenital talipes equinovarus and preterm delivery were noted. The most common organism isolated was Staphylococcus aureus (35%); however, atypical organism was Acinetobacter haemolyticus (2.5%). Among treatment methods, surgical cleaning, arthrotomy, and drainage was the most common procedure. The greater the delay in institutional visit, the more severe was the complications. Worst outcomes and sequelae are seen when the delay is >3 months, namely epiphyseal growth arrest, varus deformity, and destroyed head of the femur; good outcomes are seen when a delay is for a few days. Conclusion: Early detection and institutional visit resulted in good outcomes. This study proves the truth behind the fact that delay in diagnosis and initiation of definitive treatment causes more complications and sequelae. This study also serves as a clinical guide to identify risk factors, awareness about early detection, and effective institutional treatment of osteoarticular infections in infants and neonates.