Osteomielitis : diagnóstico diferencial para tratamiento en pacientes escolares
Fecha
2023
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
Introducción: La osteomielitis es una patología de carácter inflamatorio e infeccioso que incapacita al paciente y frustrante al personal médico. Se exponen conceptos, definiciones, clasificación, etiología y diagnóstico diferencial para su tratamiento.
Objetivo: Determinar los factores que complican el diagnóstico diferencial de osteomielitis para su posterior el tratamiento en escolares atendidos en el
HFIB durante el período de enero de 2019 a enero 2021.
Metodología: Estudio de enfoque cuantitativo de corte transversal, descriptivo, analítico, retrospectivo y no experimental.
Resultados: Se evidencia una prevalencia en pacientes en edad escolar con un 40.38%. el diagnóstico inicial con el que más se confunde a la
osteomielitis es con celulitis con 28.6%. Los factores de riesgo corresponden 66.7% al masculino, 28.6% de los pacientes de 9 años y procedencia rural del 57.1%, manipulación de la zona traumatizada con masajes con 61.9%. El cuadro clínico que presentaron los pacientes el 71.4% es de fiebre, todos evidenciaron signos de inflamación local. En los exámenes de laboratorios la leucocitosis se presentó en el 64.3% y PCR elevada en 52.4%. en los cultivos, el agente bacteriano aislado en el 50% fue el S. aureus.
Conclusiones: La osteomielitis es frecuente en edad escolar a en el género masculino, el diagnóstico inicial es confundido con celulitis. Los factores de
riesgo más importante es la procedencia rural y la manipulación de los pacientes.
El Staphylococcus aureus es el agente etiológico principal y sus manifestaciones clínicas son signos de inflamación local y fiebre, leucocitosis y PCR elevada
Introduction: Osteomyelitis is an inflammatory and infectious pathology that incapacitates the patient and frustrates the medical staff. Concepts, definitions, classification, etiology and differential diagnosis for its treatment are exposed. Objective: To determine the factors that complicate the differential diagnosis of osteomyelitis for its subsequent treatment in schoolchildren attended at the HFIB during the period from January 2019 to January 2021. Methodology: Study with a quantitative, cross-sectional, descriptive, analytical, retrospective and non-experimental approach. Results: A prevalence in patients of school age with 40.38% is evident. the initial diagnosis with which osteomyelitis is most confused is with cellulitis with 28.6%. The risk factors correspond 66.7% to the male, 28.6% of the 9-year-old patients and 57.1% rural origin, manipulation of the traumatized area with massages with 61.9%. The clinical picture presented by the patients in 71.4% is fever, all showed signs of local inflammation. In laboratory tests, leukocytosis occurred in 64.3% and elevated PCR in 52.4%. in the cultures, the bacterial agent isolated in 50% was S. aureus. Conclusions: Osteomyelitis is frequent in school age and in the male gender, the initial diagnosis is confused with cellulitis. The most important risk factors are the rural origin and the handling of the patients. Staphylococcus aureus is the main etiological agent and its clinical manifestations are signs of local inflammation and fever, leukocytosis and elevated CRP.
Introduction: Osteomyelitis is an inflammatory and infectious pathology that incapacitates the patient and frustrates the medical staff. Concepts, definitions, classification, etiology and differential diagnosis for its treatment are exposed. Objective: To determine the factors that complicate the differential diagnosis of osteomyelitis for its subsequent treatment in schoolchildren attended at the HFIB during the period from January 2019 to January 2021. Methodology: Study with a quantitative, cross-sectional, descriptive, analytical, retrospective and non-experimental approach. Results: A prevalence in patients of school age with 40.38% is evident. the initial diagnosis with which osteomyelitis is most confused is with cellulitis with 28.6%. The risk factors correspond 66.7% to the male, 28.6% of the 9-year-old patients and 57.1% rural origin, manipulation of the traumatized area with massages with 61.9%. The clinical picture presented by the patients in 71.4% is fever, all showed signs of local inflammation. In laboratory tests, leukocytosis occurred in 64.3% and elevated PCR in 52.4%. in the cultures, the bacterial agent isolated in 50% was S. aureus. Conclusions: Osteomyelitis is frequent in school age and in the male gender, the initial diagnosis is confused with cellulitis. The most important risk factors are the rural origin and the handling of the patients. Staphylococcus aureus is the main etiological agent and its clinical manifestations are signs of local inflammation and fever, leukocytosis and elevated CRP.
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OSTEOMIELITIS, DIAGNOSTICO DIFERENCIAL, TRATAMIENTO, ESCOLARES, PEDIATRIA, HOSPITAL DEL NIÑO FRANCISCO DE ICAZA BUSTAMANTE, CANTON GUAYAQUIL, ECUADOR