PEDIATRIC OSTEOMYELITIS AND SEPTIC ARTHRITIS - PATHOLOGY OF NEONATAL DISEASE

Abstract

The morphologic and histologic examination of over 55 foci of metaphyseal/epiphyseal osteomyelitis and 11 septic joints from 5 patients with neonatal osteomyelitis and joint sepsis are described. [All pathologies were due to Staphylococcus aureus]. The severity of the bone and joint involvement varied considerably, allowing a better understanding of the pathophysiologic sequence of events in the disease in the neonatal time period. Of particular importance were the multifocal nature of the disease, the highly variable destruction of the growth plate (physis) by several discrete mechanisms and the invasion of the chondroepiphysis through the cartilage canal systems. Of the cases, 2 died from respiratory complications several months following presumed successful treatment of their skeletal infections. Specimens showed significant growth plate damage continuing beyond the neonatal period. Rapid diagnosis and drainage, whenever feasible, are needed to prevent long-term skeletal growth damage. The severity of involvement emphasizes that this disease, especially in the neonate, is not an innocuous condition.