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Staphylococcal Infections

PEDIATRICS Vol. 106 No. 6 December 2000, p. e87

ELECTRONIC ARTICLE:
The Pivotal Role of Deep Vein Thrombophlebitis in the Development of Acute Disseminated Staphylococcal Disease in Children

Received Feb 29, 2000; accepted Jul 11, 2000.

Arkadi Gorenstein*, Eitan GrossDagger , Sion Houri*, Gabriella Gewirts*, and Schmuel Katz, §

From the * Department of Pediatric Surgery, * Wolfson Medical Center, Holon, Israel; Dagger  Department of Pediatric Surgery, Hadassah University Hospital, Ein Kerem, Jerusalem; and the § Department of Pediatric Surgery, Meir General Hospital, Kfar Saba, Israel.

Deep vein thrombophlebitis (DVT) and septic pulmonary emboli (PE) are rare in children. The association of DVT and acute disseminated staphylococcal disease (DSD) during childhood has not been previously reported. We report 3 children who developed a triad of DVT, septic PE, and acute osteomyelitis with Staphylococcus aureus cultured from blood and bone. One child succumbed, while 2 survived following prolonged, morbid hospitalizations. The rapid clinical deterioration observed in these patients might be caused by the aggressiveness of staphylococcal infection combined with an ongoing showering of septic emboli from the ileo-femoral DVT. We suggest that infected DVT with septic PE had a pivotal role in the development of DSD in these children. The presence of this triad should prompt aggressive treatment with the appropriate antibiotics, anticoagulation, surgical drainage, and assisted ventilation when indicated.

 Key words:  deep vein thrombophlebitis, disseminated staphylococcal disease, osteomyelitis, pediatric, septic pulmonary emboli.




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Osteomyelitis and Deep Vein thrombosis
Anuj Madan Walia
Pediatrics Online, 28 Apr 2003 [Full text]