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Martin VT, Dhagey IA, Wu H, Xu S, Yu B. Systematic Review of Heel Puncture-Related Osteomyelitis of the Calcaneus in Newborn Infants. Infect Dis Ther 2024; 13:991-1004. [PMID: 38589762 PMCID: PMC11098976 DOI: 10.1007/s40121-024-00957-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/06/2024] [Indexed: 04/10/2024] Open
Abstract
INTRODUCTION Heel puncture (HP) in neonates can result in osteomyelitis if done non-aseptically or with incorrect technique. This study summarizes clinical experience with heel puncture-related osteomyelitis of the calcaneus (HP-CO) in newborns. METHODS We systematically reviewed studies that examined HP-CO in newborn patients using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our search included the PubMed, Embase, and Cochrane Library databases until December 31, 2023. We used the National Institutes of Health (NIH) assessment scale to evaluate the quality of our analyzed studies. RESULTS This study analyzed 15 neonatal calcaneal osteomyelitis (CO) cases due to HP conducted in six countries from 1976 to 2016. The average age of the cases was 8.87 ± 6.13 days, with an average birth weight of 2367.27 ± 947.59 g. The infants had undergone an average of 9.00 ± 8.90 HP, with 93.33% exhibiting swelling. Staphylococcus aureus was present in 80% of cases. Beta-lactam antibiotics were used, with satisfactory outcomes in 53.33% of cases. However, in seven cases, three patients had flatfoot due to calcaneal deformity, and other complications were observed in some patients after 7-8 years. CONCLUSIONS This study offers valuable insights into a rare condition, including its epidemiology, clinical and laboratory characteristics, and treatment options for infants with HP-CO. To prevent the risk of osteomyelitis in this vulnerable group of patients, increasing awareness and maintaining strict aseptic techniques is necessary. We recommend that infants presenting with tenderness, redness, purulent discharge, erythema, or fever and with a history of repeated HP and swollen ankles should be evaluated for suspicion of osteomyelitis. A graphical abstract is avilable for this article.
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Affiliation(s)
- Vidmi Taolam Martin
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
- Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
| | - Ismail Ahmed Dhagey
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Hangtian Wu
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
- Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Shaoyong Xu
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
- Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Bin Yu
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
- Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
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Noureldein M, Gowda H. Question 2: Is it safe to use the centre of the heel for obtaining capillary blood samples in neonates? Arch Dis Child 2018; 103:401-404. [PMID: 29348114 DOI: 10.1136/archdischild-2017-314214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 12/27/2017] [Accepted: 12/29/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Mona Noureldein
- Neonatal Unit, Luton and Dunstable University Hospital NHS Foundation Trust, Luton, UK
| | - Harsha Gowda
- Neonatal Unit, Luton and Dunstable University Hospital NHS Foundation Trust, Luton, UK
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Mallia AJ, Ashwood N, Arealis G, Bindi F, Zamfir G, Galanopoulos I. Delayed recognition of pediatric calcaneal osteomyelitis: a case report. J Med Case Rep 2015; 9:185. [PMID: 26329390 PMCID: PMC4557822 DOI: 10.1186/s13256-015-0657-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 07/20/2015] [Indexed: 11/10/2022] Open
Abstract
Introduction The diagnosis of calcaneal osteomyelitis is a challenge, and diagnostic delays have been reported in the literature. The progression is often indolent, laboratory results commonly fail to reveal an underlying infectious process and radiographs changes are seen after 7 days. We discuss the literature on the diagnosis and treatment of calcaneal osteomyelitis which can result in long-term sequelae in the pediatric patient. Case presentation A 9-year-old white boy presented to our institution with heel pain and an inability to weight bear. There was a 10-day delay in diagnosis of calcaneal osteomyelitis, with a total of three presentations to our emergency department. The condition was misdiagnosed as Sever’s disease on two separate occasions with discharge home. On his third presentation the diagnosis was finally clinched when he developed more definitive signs and symptoms, with pyrexia and signs of lymphangitis. Magnetic resonance imaging revealed diffuse osteomyelitis of his calcaneum. He underwent surgery and 2 weeks of antibiotics administered intravenously, followed by 4 weeks of oral therapy. We are happy to report a good recovery without any complications at his 12-month follow up. Conclusions Physicians should include calcaneal osteomyelitis as a differential in any child presenting with heel pain. Delays in the diagnosis can result in disastrous complications in the pediatric patient, such as growth arrest.
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Affiliation(s)
- Alvin James Mallia
- Department of Trauma and Orthopaedics, Queens Hospital Burton, Burton-on-Trent, UK.
| | - Neil Ashwood
- Department of Trauma and Orthopaedics, Queens Hospital Burton, Burton-on-Trent, UK.
| | - Georgios Arealis
- Department of Trauma and Orthopaedics, Queens Hospital Burton, Burton-on-Trent, UK.
| | - Frank Bindi
- Department of Trauma and Orthopaedics, Queens Hospital Burton, Burton-on-Trent, UK.
| | - Georgiana Zamfir
- Department of Trauma and Orthopaedics, Queens Hospital Burton, Burton-on-Trent, UK.
| | - Ilias Galanopoulos
- Department of Trauma and Orthopaedics, Queens Hospital Burton, Burton-on-Trent, UK.
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