PEDIATRICS Vol. 69 No. 4 April 1982, pp. 432-435
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Management of Pseudomonas Osteochondritis Complicating Puncture Wounds of the Foot

Richard F. Jacobs MD1, Lee Adelman RN1, Carolyn M. Sack MD1, and Christopher B. Wilson MD1

1 Division of Infectious Diseases, Department of Pediatrics, Children's Orthopedic Hospital and Medical Center, and The University of Washington School of Medicine, Seattle

Pseudomonas osteochondritis following puncture wounds of the foot is described in 13 children. All children had received at least one oral antibiotic and local wound therapy before admission; none had improved on these modalities. Pseudomonas aeruginosa was isolated alone from seven patients and with one or more other organisms from six patients. Initial administration of parenteral antibiotics active against Pseudomonas for one to 14 days did not result in clinical improvement. Eradication of Pseudomonas osteochondritis occurred in each patient only after thorough surgical debridement and curettage of all infected tissue. Following thorough surgical debridement, anti-Pseudomonas antibiotic therapy was continued for five to 14 days (10.8 ± 2.7 days). The successful treatment of Pseudomonas osteochondritis should include adequate surgical debridement of all infected tissue; following thorough debridement, only one to two weeks of anti-Pseudomonas antibiotic therapy appears to be necessary.

Submitted on May 11, 1981
Accepted on June 19, 1981


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