<i>Fusobacterium</i> Species in Osteoarticular Infections in Childhood—A Systematic Review with Data Synthesis and a Case Series in the Acetabular and Hip Joint Regions
<b>Background</b>: In paediatric osteoarticular infections, microorganism detection is unsuccessful in up to 55% of cases, which is not satisfactory for targeted antibiotic therapy. In particular, anaerobic fusobacteria may be underdiagnosed owing to a lack of knowledge about their prope...
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2025-04-01
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| author | Heide Delbrück Silvia Schröder Tom Stapper Sabine Schacht Angeliki Pappa Frank Hildebrand Miriam Katharina Hertwig |
| author_facet | Heide Delbrück Silvia Schröder Tom Stapper Sabine Schacht Angeliki Pappa Frank Hildebrand Miriam Katharina Hertwig |
| author_sort | Heide Delbrück |
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| description | <b>Background</b>: In paediatric osteoarticular infections, microorganism detection is unsuccessful in up to 55% of cases, which is not satisfactory for targeted antibiotic therapy. In particular, anaerobic fusobacteria may be underdiagnosed owing to a lack of knowledge about their properties. <b>Methods</b>: Based on three of our own cases and a systematic literature review regarding paediatric osteoarticular fusobacterial infections, we extracted characteristic variables and synthesised them in terms of frequencies and mean comparisons. We followed the CARE and PRISMA guidelines. <b>Results</b>: In our three patients with hip area infections (aged 11, 12, and 16 years; two males and one female; two with <i>Fusobacterium nucleatum</i> [FNU] and one with <i>Fusobacterium necrophorum</i> [FNE]), we only detected FNU with PCR. The patient with an FNE infection showed a septic and protracted course with six surgical interventions and secondary coxarthrosis during the follow-up. The FNU infections were milder and healed without sequelae. In the literature, there are no articles with more than 3 cases; overall, we identified 38 case reports and 3 case series with a total of 45 patients. Across all synthesised cases (73% boys), the age was 9.2 ± 4.1 years. Most patients (42%) were affected by hip joint arthritis, with or without accompanying acetabular or femoral osteomyelitis, followed by knee joint arthritis, with or without osteomyelitis, in 24% of patients. In 49% of cases, there was an ear, nose, and throat focus. Depending on the affected structure, arthrotomy (33%), arthroscopy (11%), bone (24%), and soft tissue (9%) debridement were performed, with 34% of the procedures having to be performed several times. Penicillins, metronidazole, and clindamycin were the most used antibiotics. In 32 cases (71%), the authors reported healing without sequelae. <b>Conclusions</b>: When samples are collected in the operating theatre for paediatric osteoarticular infections, orthopaedic surgeons should also ensure correct anaerobic sampling and consider the possibility of performing PCR. A typical child with an osteoarticular fusobacterial infection is a boy of approximately 10 years of age with an infection in the hip area and a previous infection in the ENT area. |
| format | Article |
| id | doaj-art-e6e7b01993624e179e461b85b4b10cd2 |
| institution | DOAJ |
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| publishDate | 2025-04-01 |
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| spelling | doaj-art-e6e7b01993624e179e461b85b4b10cd22025-08-20T03:13:47ZengMDPI AGInfectious Disease Reports2036-74492025-04-011723010.3390/idr17020030<i>Fusobacterium</i> Species in Osteoarticular Infections in Childhood—A Systematic Review with Data Synthesis and a Case Series in the Acetabular and Hip Joint RegionsHeide Delbrück0Silvia Schröder1Tom Stapper2Sabine Schacht3Angeliki Pappa4Frank Hildebrand5Miriam Katharina Hertwig6Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, GermanyDepartment of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, GermanyCenter for Paediatric & Adolescent Medicine, Mönchengladbach Municipal Clinics, Elisabeth-Krankenhaus Rheydt, Hubertusstrasse 100, 41239 Mönchengladbach, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, GermanyDepartment for Paediatrics and Adolescent Medicine, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, GermanyDepartment of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, GermanyDepartment of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany<b>Background</b>: In paediatric osteoarticular infections, microorganism detection is unsuccessful in up to 55% of cases, which is not satisfactory for targeted antibiotic therapy. In particular, anaerobic fusobacteria may be underdiagnosed owing to a lack of knowledge about their properties. <b>Methods</b>: Based on three of our own cases and a systematic literature review regarding paediatric osteoarticular fusobacterial infections, we extracted characteristic variables and synthesised them in terms of frequencies and mean comparisons. We followed the CARE and PRISMA guidelines. <b>Results</b>: In our three patients with hip area infections (aged 11, 12, and 16 years; two males and one female; two with <i>Fusobacterium nucleatum</i> [FNU] and one with <i>Fusobacterium necrophorum</i> [FNE]), we only detected FNU with PCR. The patient with an FNE infection showed a septic and protracted course with six surgical interventions and secondary coxarthrosis during the follow-up. The FNU infections were milder and healed without sequelae. In the literature, there are no articles with more than 3 cases; overall, we identified 38 case reports and 3 case series with a total of 45 patients. Across all synthesised cases (73% boys), the age was 9.2 ± 4.1 years. Most patients (42%) were affected by hip joint arthritis, with or without accompanying acetabular or femoral osteomyelitis, followed by knee joint arthritis, with or without osteomyelitis, in 24% of patients. In 49% of cases, there was an ear, nose, and throat focus. Depending on the affected structure, arthrotomy (33%), arthroscopy (11%), bone (24%), and soft tissue (9%) debridement were performed, with 34% of the procedures having to be performed several times. Penicillins, metronidazole, and clindamycin were the most used antibiotics. In 32 cases (71%), the authors reported healing without sequelae. <b>Conclusions</b>: When samples are collected in the operating theatre for paediatric osteoarticular infections, orthopaedic surgeons should also ensure correct anaerobic sampling and consider the possibility of performing PCR. A typical child with an osteoarticular fusobacterial infection is a boy of approximately 10 years of age with an infection in the hip area and a previous infection in the ENT area.https://www.mdpi.com/2036-7449/17/2/30<i>Fusobacterium</i>childrenpaediatricosteoarticular infectionsmusculoskeletal infectionsbone and joint infections |
| spellingShingle | Heide Delbrück Silvia Schröder Tom Stapper Sabine Schacht Angeliki Pappa Frank Hildebrand Miriam Katharina Hertwig <i>Fusobacterium</i> Species in Osteoarticular Infections in Childhood—A Systematic Review with Data Synthesis and a Case Series in the Acetabular and Hip Joint Regions Infectious Disease Reports <i>Fusobacterium</i> children paediatric osteoarticular infections musculoskeletal infections bone and joint infections |
| title | <i>Fusobacterium</i> Species in Osteoarticular Infections in Childhood—A Systematic Review with Data Synthesis and a Case Series in the Acetabular and Hip Joint Regions |
| title_full | <i>Fusobacterium</i> Species in Osteoarticular Infections in Childhood—A Systematic Review with Data Synthesis and a Case Series in the Acetabular and Hip Joint Regions |
| title_fullStr | <i>Fusobacterium</i> Species in Osteoarticular Infections in Childhood—A Systematic Review with Data Synthesis and a Case Series in the Acetabular and Hip Joint Regions |
| title_full_unstemmed | <i>Fusobacterium</i> Species in Osteoarticular Infections in Childhood—A Systematic Review with Data Synthesis and a Case Series in the Acetabular and Hip Joint Regions |
| title_short | <i>Fusobacterium</i> Species in Osteoarticular Infections in Childhood—A Systematic Review with Data Synthesis and a Case Series in the Acetabular and Hip Joint Regions |
| title_sort | i fusobacterium i species in osteoarticular infections in childhood a systematic review with data synthesis and a case series in the acetabular and hip joint regions |
| topic | <i>Fusobacterium</i> children paediatric osteoarticular infections musculoskeletal infections bone and joint infections |
| url | https://www.mdpi.com/2036-7449/17/2/30 |
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