Search

Background. Cryptococcus neoformans causes cryptococcosis, primarily affecting immunocompromised individuals, including solid-organ transplant recipients, and, less frequently, immunocompetent people. Case. A 15-year-old male with congenital hepatic fibrosis, portal hypertension, and cirrhosis underwent orthotopic liver transplantation. He received perioperative antimicrobial and antifungal prophylaxis and continued immunosuppressive treatment. Thirty months post-transplant, he presented with fever, hypertension, and sacroiliac joint pain. Peripheral blood cultures showed C. neoformans, confirmed by pan-fungal polymerase chain reaction assay and latex agglutination tests. Despite initial treatment with intravenous (IV) fluconazole, his condition worsened, necessitating intubation for acute hypoxic respiratory failure. Magnetic resonance imaging and computed tomography scans indicated disseminated cryptococcosis with lymphadenitis, possible meningitis, and pneumonia. Treatment was escalated to IV liposomal amphotericin B and 5-flucytosine, while reducing immunosuppressive treatment. Despite negative fungal cultures on the tenth day, the patient deteriorated, developing pancreatitis, pneumonia, and massive gastrointestinal bleeding, leading to death on the 35th day of hospitalization. Conclusion. This case shows the severity and complexity of managing disseminated cryptococcosis in pediatric liver transplant recipients. Aggressive therapy and early identification are essential for improving outcomes in these high-risk patients. [ABSTRACT FROM AUTHOR]

Aim: The children of healthcare workers (HCWs) constitute a group highly vulnerable to anxiety disorders during the coronavirus disease-2019 (COVID-19) pandemic. This study aimed to compare the prevalence and severity of anxiety between the children of HCWs and non-HCWs while identifying factors contributing to this anxiety. Materials and Methods: A cross-sectional study was conducted involving 334 children aged between 6 and 17 years to assess their anxiety levels. The risk factors related to anxiety were determined using binary logistic regression analysis. Results: Significant risk factors for anxiety included having parents who were HCWs, having parents with psychiatric disorders, changes in household members, and following news updates (p=0.045, 0.022, 0.021, and 0.024, respectively). Children of HCWs working in COVID-19 clinics exhibited a higher prevalence of moderate to severe anxiety than the other groups (p=0.036). Additionally, prolonged screen time and changes in sleep duration were more common in children with moderate to severe anxiety. Conclusion: The results suggest that the children of HCWs may be more prone to anxiety symptoms than the children of parents in other professions. [ABSTRACT FROM AUTHOR]

Objective: It is known that coronavirus disease-2019 (COVID-19) showed a clinical course with milder symptoms in children than in adults. However, a multisystem inflammatory syndrome in children (MIS-C), which developed 2-4 weeks after COVID-19 infection, emerged in April 2021. Other respiratory viruses such as influenza, respiratory syncytial virus, and parainfluenza spread worldwide after loosening pandemic restrictions. Pediatricians were challenged to distinguish COVID-19, MIS-C, and other viral infections from each other. Herein, we have aimed to determine basic, simple hematological parameters that can predict the prognosis and outcomes of the patients with COVID-19 and MIS-C. Method: In this study, 300 pediatric inpatients including those with MIS-C, COVID-19, and other respiratory virus infections admitted to Ege University Faculty of Medicine between January 2018 and September 2021, were retrospectively evaluated. Results: The neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-monocyte ratio (NMR), derived NLR, and the systemic inflammatory index were higher in the MIS-C patients compared to others. The lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) were lower in children with COVID-19 disease than those with MIS-C (p<0.05). Conclusions: In this study, we have shown that commonly used hematological tests, especially higher values of NLR, NMR for children with MIS-C, and lower levels of LMR for children with COVID-19, are significant and can help to determine the possible disease course of children at an early stage. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Pediatric Infection / Çocuk Enfeksiyon Dergisi is the property of Journal of Pediatric Infection / Cocuk Enfeksiyon Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVES: Coronavirus disease 2019 (COVID-19) that causes a respiratory illness, continues to be a global pandemic. In this study, we purpose to identify the features of children with COVID-19 and the factors affecting disease severity. METHODS: This is a retrospective, observational study was conducted on patients who presented with suspicion of COVID-19 from April 1, 2020, to March 31, 2021, at a tertiary care medical center in Turkey. The characteristics of 640 children who were confirmed to have COVID-19 by real-time reverse transcription-polymerase chain reaction were retrieved from medical records. RESULTS: The mean age of the cases was 10 ± 6 years, and 56% of them were male. Seasonal difference did not affect the number of cases. The majority of the cases (n = 501, 78%) were infected by family members. Fever (67%) and cough (38%) were common complaints. The mean duration of fever was 1.9 ± 1.1 days. One-fourth of the cases were asymptomatic, 462 (72%) had mild upper respiratory tract infections, and 18 (3%) had pneumonia. Patients with pneumonia were more likely to have comorbidities and had a longer fever duration (both P < 0.001). Fever, cough, and respiratory distress were more common in patients with pneumonia (P = 0.010, P = 0.023, and P < 0.001, respectively). The mean C-reactive protein (CRP) value of the patients with pneumonia was significantly higher than that of the others (P < 0.001). A total of 70 (11%) complicated patients were hospitalized, 5 of them requiring intensive care admission. All hospitalized patients were discharged with recovery. CONCLUSIONS: Although pediatric COVID-19 patients tended to have a mild disease, some children with comorbidities can still develop a severe illness. CRP value is a useful indicator in the diagnosis of COVID-19 pneumonia. Furthermore, the prevalence rate of COVID-19 did not decrease with hot seasons. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Pediatric Infection / Çocuk Enfeksiyon Dergisi is the property of Journal of Pediatric Infection / Cocuk Enfeksiyon Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In early December, pneumonia cases of unknown origin started to appear and, on the 7th of January 2020, these cases were declared to be caused by a novel beta-coronavirus according to viral genome sequencing on the 11th of February, 2020. Coronaviruses are enveloped, single strand RNA viruses that have been known to have the ability to mutate rapidly, alter tissue tropism and adjust to different epidemiological situations. As of the end of April 2020, 122,392 laboratory-confirmed cases of COVID-19 had been detected in Turkey, of whom 3,258 died. From the beginning of the COVID-19 epidemic, children seem to be less affected than adults. Therefore, there are limited data regarding the clinical features of COVID-19 in children. The majority of children with confirmed COVID-19 had a history of household contact. The most common symptoms were fever and cough. Previous data suggest that nearly half of patients are afebrile at the onset of the disease. Hospitalization and PICU admission rates for children were lower than for adults. However, PICU admission can be necessitated in children with severe disease. Infants, particularly under the age of 12 months, were more likely to develop severe disease. In children, milder and asymptomatic cases can be challenging and can play a role in transmission. In particular, clinicians should test those children who have a history of family cluster even though they are asymptomatic or present with mild symptoms. [ABSTRACT FROM AUTHOR]

Aim: Bloodstream infections are serious conditions that can cause significant morbidity and mortality. Early recognition of the bacteria and targeted early treatment play an important role in prognosis. The Verigene Gram-negative blood culture nucleic acid test (BC-GN; Nanosphere, USA) is a new method that can accurately identify both Gram-negative bacteria and resistance genes within 2 hours. In this study, we aimed to determine the accuracy of this assay for the rapid identification of certain Gram-negative microorganisms in children with bloodstream infections and to compare with the conventional culture method. Materials and Methods: A total of 30 patients (<18 years-old) (followed up in the Department of Pediatrics of Ege University Faculty of Medicine between December 2015-June 2016) with bloodstream infections due to Gram-negative bacteria were prospectively included. Microarray test results were compared with conventional blood culture results. Results: Klebsiella spp. (40%) were the most common and Acinetobacter spp. (20%) were the second most commonly seen Gram-negative microorganisms detected. Accurate identification via microarray analysis was 100% (12/12) for Klebsiella spp, 100% (6/6) for Acinetobacter spp., 100% (5/5) for Escherichia coli, 80% (4/5) for Enterobacter cloacae spp., 100% (1/1) for Pseudomonas aeruginosa and 100% (1/1) for Citrobacter amalonaticus, respectively. The test was able to correctly identify 96.5% of Gram-negative microorganisms that were located in the test panel. CTX-M was the most common gene responsible for resistance. Conclusion: The Verigene Gram-negative (BC-GN) microarray test (Nanosphere) is a rapid method which can correctly identify the located Gram-negative microorganisms in the panel and give results much faster than conventional methods. [ABSTRACT FROM AUTHOR]

Aim: Infections and sepsis are the leading causes of death in non-cardiac intensive care units (ICUs) and account for 40 percent of all ICU expenditures. Data regarding bloodstream infections (BSIs) due to a carbapenem-resistant gram negative (CRGN) microorganisms in pediatric ICUs still remain limited. Materials and Methods: This study was conducted retrospectively in patients who were admitted to two pediatric critical care units between January 2011 and December 2017. Patients were assigned to two groups. Patients with BSI caused by a CRGN microorganism and infections were assigned to the BSI group and those other than BSI were assigned to the non-BSI group. Results: This study included 89 critically ill children with a mean age of 52.1 (±65.1) months. The requirements for invasive procedures including tracheostomy, Foley catheter and central venous catheter were not statistically different among the groups, p values were 0.159, 0.291 and 0.803, respectively. The majority of the patients admitted to pediatric intensive care unit were due to sepsis/septic shock in the BSI group (n=18, 58%) and in the non-BSI group, this figure was 37.9% (n=24). Prior third/fourth generation cephalosporin exposure was significantly more common in the BSI group (51.6% vs 15.5%, p<0.001), carbapenem exposure was not significantly different among the groups (35.5% vs 56.9%, p=0.054). Neutropenia (<500/mm3) and thrombocytopenia (150x103/mm3) were significantly more common in the BSI group (p=0.011 and p=0.010) and the C-reactive protein level was significantly higher (p=0.018). Crude and attributable mortality did not show any significance between the groups, p values were 0.578 and 0.955, respectively. Conclusion: CRGN infections are still a major cause of morbidity, mortality and healthcare associated infections. In this study, we evaluated patients with BSI due to a CRGN microorganism and compared them with other infection types. The risk factors and outcomes were similar except for prior cephalosporin exposure. As a conclusion, we have to enhance infection control programs and prevent patients from redundant antibiotic exposure. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the outcomes including morbidity and mortality of carbapenem-resistant gram-negative (CRGN) infections in pediatric critical care setting. The second aim was to investigate the impact of aminoglycosides on colistin-containing regimen in CRGN-infected pediatric critical care patients. Materials and Methods: We retrospectively evaluated medical records of 82 patients who had received colistin in combination with an aminoglycoside (CA group) or another antibiotic (CO group) at two reference pediatric intensive care units (PICUs) between February 2011 and February 2016. Results: We enrolled 82 CRGN-infected patients who were admitted to PICUs of two hospitals. The median age of the patients was 24 (25th–75th percentile; 8–78.75) months, and the median duration of hospital stay was 30 days (25th–75th percentile; 16.7–57.7). No statistical difference was observed in the variables, including microbiological response, attributable mortality, crude mortality, and the duration of achieving first negative culture (p>0.05). Clinical response was significantly more observed in the CA group (85.5% vs. 63.2; p=0.048), and attributable mortality was higher in the CO group (12.7% vs. 31.6%; p=0.055). Nephrotoxicity did not show statistical difference between groups (p=0.357), and neurotoxicity was not observed. Conclusion: Colistin-containing regimen in combination with an aminoglycoside may be an effective and safe antimicrobial agent without a significant increase in side effects. [ABSTRACT FROM AUTHOR]

Aim: Despite improvements in diagnosis and treatment, infections are still major cause of morbidity and mortality in children with febrile neutropenia (FN). In these patients, due to inadequate inflammatory response and subtle clinical symptoms, to determine the source of infection can be challenging. Therefore, it is important to distinguish infections from other non-infectious causes, for both to choose appropriate antibiotic and to reduce the redundant antibiotic use. Materials and Methods: In this retrospective study, we aim to evaluate serial procalcitonin (PCT) levels for predicting bacteremia particularly caused by Gram-negative microorganism. Results: Among FN episodes caused by Gram-negative microorganism, the median level of second PCT sample obtained between 48 and 72 hours PCT 2 was found to be significantly higher when compared to infections caused by Coagulase-negative Staphylococcus or culturenegative confirmed infections, p value was 0.003; however, fever onset PCT 1 and C-reactive protein (CRP) 1 values showed no significant difference (p>0.05). The area under curve values demonstrated by receiver operating characteristic (ROC) analysis for CRP 1, CRP 2, PCT 1, PCT 2 were 0.664, 0.748, 0.504 and 0.842, respectively. Conclusion: This study showed that initial PCT levels were not significantly correlate with culture-confirmed bacterial infection. Therefore, initial PCT values do not help the clinicians in terms of administering or postponing empirical antibiotics at the time of fever onset. However, third day PCT levels present as a good diagnostic marker due to a higher sensitivity and specificity when comparing them to the initial values. Determination of serial PCT may enhance the diagnostic value of PCT diagnostic marker in FN episodes caused by Gram-negative bacteria with a high sensitivity (87.5%). This study also demonstrated that PCT could be used to rule out bacterial infections particularly caused by Gram-negative bacteria. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Pediatric Research is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Pediatric Infection / Çocuk Enfeksiyon Dergisi is the property of Journal of Pediatric Infection / Cocuk Enfeksiyon Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Despite improvements in diagnosis and treatment, infections are still a major cause of morbidity and mortality in children with febrile neutropenia. In the majority of febrile episodes, the source of infection cannot be defined. In this study, we aimed to identify the earlier predictors of bacteremia/fungemia and a useful cytokine to identify the source of infection and to discriminate the patients with culture-confirmed bacterial/fungal infection. The most sensitive cytokine was interleukin (IL)-10 and the most specific was IL-8 in predicting culture-confirmed cases. IL-8 had greater sensitivity and specificity in determination of gram-negative bacterial infections with a higher negative predictive value; therefore, IL-8 can be used particularly to rule out gram-negative bacterial infections. IL-6, IL-8, and IL-10 circulating levels were shown to be higher in cases of infection. Further studies are needed to recommend a routine practice for predicting culture-confirmed bacterial infections. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Pediatric Infection / Çocuk Enfeksiyon Dergisi is the property of Journal of Pediatric Infection / Cocuk Enfeksiyon Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Pediatric Infection / Çocuk Enfeksiyon Dergisi is the property of Journal of Pediatric Infection / Cocuk Enfeksiyon Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Pediatric Infection / Çocuk Enfeksiyon Dergisi is the property of Journal of Pediatric Infection / Cocuk Enfeksiyon Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: Herpes zoster (HZ) is a vesicular cutaneous infection caused by reactivation of the latent varicella-zoster virus from dorsal root ganglia. It is characterized by dermatome distribution. It is usually seen in the elderly and pediatric zoster is rare. In this study we evaluated 16 patients who were admitted to our pediatric clinic and diagnosed as HZ. Material and Method: Sixteen patients aged between 12 months and 17 years who were admitted to Ege University Medical Faculty Children Hospital and Tepecik Education and Research Hospital Pediatric Infection departments between January 2010 and September 2011 were evaluated retrospectively. Previous varicella disease, varicella vaccination history, existing chronic disease, immunodeficiency, immunosuppressive drug use, trauma, history of operation, history of radiation and presence of stress were questioned. Results: Nine of 16 patients who were diagnosed as HZ were female. Three patients had lumbar involvement, six had thoracic involvement, one had disseminated involvement, four had trigeminal involvement, one had cervical involvement and one had sacral involvement. All patients received systemic and local treatment. No complication was observed. Conclusions: Herpes zoster may be observed in children with or without immune suppression. The disease is benign in healthy children. Complications are rare. [ABSTRACT FROM AUTHOR]

Copyright of Türk Pediatri Arşivi is the property of Aves Yayincilik Ltd. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Pediatric Infection / Çocuk Enfeksiyon Dergisi is the property of Journal of Pediatric Infection / Cocuk Enfeksiyon Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Pediatric Infection / Çocuk Enfeksiyon Dergisi is the property of Journal of Pediatric Infection / Cocuk Enfeksiyon Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Amaç: İnvazif fungal enfeksiyonlar, sınırlı tedavi seçenekleri nedeniyle hastanede yatan ve bağışıklığı baskılanmış çocuk hastalarda önemli bir mortalite ve morbidite nedenidir. Mikafungin, çocuk hastalarda invazif fungal enfeksiyonların tedavisi için en yeni onaylanmış ekinokandin grubu bir antifungaldir; ancak, çocuklarda etkililik ve yan etkileri hakkındaki veriler sınırlıdır. Bu çalışmada, mikafungin tedavisi veya profilaksisi kullanan çocuk hastaların özelliklerinin, tedaviye yanıtlarının ve yan etki sıklığının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Tek merkezde, Ocak 2017-Aralık 2019 tarihleri arasında tedavi veya profilaksi için mikafungin kullanan <18 yaş çocuk hastalar geriye dönük olarak değerlendirildi. Bulgular: Çalışmamızda profilaksi için mikafungin kullanan 52 hasta ve tedavi için mikafungin kullanan 39 hastanın 43 epizodu değerlendirildi. Tedavi için mikafungin kullanan hastaların yaş ortalaması 5,93±6,1 yıl ve profilaksi için mikafungin kullanan hastaların yaş ortalaması 5,54±5,0 yıl idi. Mikafungin tedavisi, 18 (%41,9) hastada etkene yönelik tedavi, 15 (%34,9) hastada ampirik tedavi ve 10 (%23,3) hastada febril nötropeni için kullanıldı. Hastaların tedavi için mikafungin kullanma süresi ortalama 16,9±10,8 gün idi. Tedavi etkinliği değerlendirildiğinde hastaların %79,1'inde klinik yanıt, %81,3'ünde mikolojik yanıt alındı. Tedavi için mikafungin kullanan hastalarda hepatik yan etki %20,9 oranında ve renal yan etki %2,3 oranında görüldü. Tedavide mikafungin kullanan hastalarda 14 günlük ve 30 günlük mortalite oranı sırasıyla %7 ve %9,3 idi. Mikafungin profilaksisi kullanan hastalarda profilaksi süresi 42 (%80,8) hastada <=1 ay ve 10 (%19,2) hastada >1 aydı. Profilaksi için mikafungin kullanan 3 (%5,8) hastada breakthrough invaziv fungal enfeksiyon gelişti (1 kanıtlanmış, 1 olası, 1 şüpheli). Profilaksi için mikafungin kullanan hastalarda hepatik yan etki %13,5 oranında ve renal yan etki %5,8 oranında görüldü. Profilaksi için mikafungin alan hastalarda 14 günlük ve 30 günlük mortalite oranı sırasıyla %0 ve %1,8 idi. Ancak, mikafungin kullanan hastalarda görülen ölümler hem profilaksi hem de tedavi gruplarında mantar enfeksiyonu ile ilişkili değildi. Sonuç: Bulgularımız, mikafunginin pediyatrik hastalarda invaziv fungal enfeksiyonların tedavisi veya profilaksisi için kullanıldığında güvenli ve etkili bir antifungal ajan olabileceğini düşündürmüştür. Çocuklarda mikafungin kullanımının etkinliğini ve güvenliğini değerlendirmek için daha fazla ve daha geniş prospektif çalışmalara ihtiyaç vardır. [ABSTRACT FROM AUTHOR]

Amaç: Çocuklarda kemik ve eklem enfeksiyonları tanı ve tedavide gelişmelere rağmen hala ciddi sekellere yol açabilmektedir. Çalışmamızda kemik ve eklem enfeksiyonu tanılı çocuk hastalarda risk faktörlerinin, laboratuvar sonuçlarının, tanı ve tedavi yaklaşımlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çocuk Enfeksiyon Servisi'nde Ekim 2014-Nisan 2021 arasında yatan 0-18 yaş arası, kemik ve eklem enfeksiyonu tanısı alan 55 hasta geriye dönük değerlendirilmiştir. Bulgular: Hastaların yaş ortalaması 8,39±5,6 yıl olup %56,4'ü erkekti. Hastaların 32'sinde (%58,2) osteomiyelit, 12'sinde (%21,8) septik artrit, 9'unda (%16,4) osteomiyelit + septik artrit, ikisinde (%3,6) septik sakroileit saptandı. Osteomiyelit olan hastaların da üçünde (%5,5) Brodie apsesi mevcuttu. Hastaların başvuru yakınması %63,6'sında şişlik, %54,5'inde hareket kısıtlılığı, %54,5'inde ağrı, %29,1'inde kızarıklık, %24,5'inde ateş, %23,6'sında ısı artışı, %16,4'ünde akıntı, %10,9'unda açık yara ve %21,8'inde hassasiyetti. Kemik eklem enfeksiyonlarında en sık tutulum yeri %25,5 oranında eklem aralığı ve en sık tutulum gösteren kemik %20 oranında femurdu. Tutulan kemik veya eklem %50,9 oranında sol taraftaydı. Hastalarda en sık altta yatan hastalık meningomiyeloseldi (%7,3). Enfeksiyona neden olabilecek altta yatan sebepler sıklık sırasıyla travma (%20), deride açık yara (%7,3), geçirilmiş cerrahi (%7,3) dental enfeksiyonlar (%3,6) ve yabancı cisimdi (%1,8). Hastaların başvuru sırasında laboratuvar tetkiklerinde ortanca lökosit sayısı 11,547/µl (minimum: 4810, maksimum: 24.140), ortanca C-reaktif protein 26 mg/L (minimum: 0, maksimum: 200), ortanca sedimentasyon 47 mm/saat (minimum: 2, maksimum: 111) idi. Tanı için %32,7 hastaya ponksiyon yapılmıştı ve tanıtedavi amacıyla %74,5 hastaya cerrahi operasyon uygulanmıştı. Alınan kan, yara sürüntü ve doku/biopsi kültürlerinde üreme %41,8 oranında saptandı ve bu üremelerin %32,7'si doku/biyopsi kültürü olarak alınmıştı. En sık etken metisilin duyarlı Staphylococcus aureus idi (%21,8). Ampirik tedavide tercih edilen intravenöz antibiyotik %49,1 oranında sefotaksim + vankomisindi. Ortalama intravenöz tedavi süresi 30,6 gün, oral antibiyotik süresi 13,8 gün, toplam tedavi süresi 45,6 gün ve hastanede yatış süresi 40,4 gündü. Görüntüleme kontrolü ortalama 27 gün sonra çekilmişti ve hastaların %54,5'inde kısmi, %16,4'ünde tam regresyon izlenmişti, %10,9'unda bulgularda değişiklik yoktu. Uzun süreli antibiyotik kullanımına bağlı hastaların %30,9'unda nötropeni, %16,4'ünde ateş, %7,3'ünde döküntü ve %7,3'ünde karaciğer fonksiyon testlerinde yükseklik gelişmişti. Yan etki en sık tedavinin üçüncü haftasında (%23,6) gözlendi. İzlemde hastaların dördünde osteomiyelit tekrarladı. Sonuç: Çocuklarda kemik ve eklem enfeksiyonlarında erken tanı konulup acil tedavi başlanması komplikasyonların önlenmesi için en önemli basamağı oluşturmaktadır. [ABSTRACT FROM AUTHOR]