Toxic shock in children with bone and joint infections: a review of seven years of patients admitted to one intensive care unit

Journal of Children's Orthopaedics
D L KerrG A Schmale

Abstract

The objective of this study was to compare the frequency of severe systemic, multi-organ involvement and toxic shock syndrome (TSS) in patients with Staphylococcus aureus (SA) and Group A β-haemolytic Streptococcus pyogenes (GABS) bone and joint infections. We retrospectively reviewed patients treated for septic arthritis or osteomyelitis at one children's hospital between 2002 and 2009. The rates of intensive care unit (ICU) admission for methicillin-sensitive SA (MSSA), methicillin-resistant SA (MRSA) and GABS infections were compared, as were the lengths of stay, number of surgeries, operative procedures and cases of TSS. A total of 16 of 208 patients (7.7%) with culture-positive bone or joint infections were admitted to the ICU for critical illness: more commonly for patients with GABS infection (7/21 or 33%) than those with SA infection (6/132 or 5%) (odds ratio 10.55, 95% confidence interval 3.093 to 35.65, p = 0.0002). Patients with MRSA infections were significantly more likely to need ICU care than those with MSSA infection (p = 0.0009). Six of the ICU patients met the Centers for Disease Control and Prevention criteria for TSS. ICU patients with MRSA and GABS bone and joint infections had similar hospital courses: num...Continue Reading

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Citations

Apr 20, 2018·Pediatrics·Arianna H DartLise E Nigrovic

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