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New Trends in the Management of Osteo-articular Infections in Children

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European Instructional Lectures

Part of the book series: European Instructional Lectures ((EICL,volume 14))

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Abstract

Although many concepts regarding the aetiology, diagnosis and treatment of osteo-articular infection in children and adolescents have remained constant in the last three decades, recently we have seen some changes in the behaviour of the infectious agents, diagnostic tools and therapeutic attitudes that make it fundamental for the young surgeon to be familiar with these new concepts, as they can be used to guide evaluation and improve treatment.

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References

  1. Agarwal A, Aggarwal AN. New Delhi: Jaypee Brothers Medical Publisher; 2013.

    Google Scholar 

  2. Arnold S, Elias D, Buckingham S, et al. Changing patterns of acute hematogenous osteomyelitis and septic arthritis: emergence of community-associated methicillin-resistant Staphylococcus aureus. J Pediatr Orthop. 2006;26:703–8.

    PubMed  Google Scholar 

  3. Ballock RT, Newton PO, Evans SJ, Estabrook M, Farnsworth CL, Bradley JS. A comparison of early versus late conversion from intravenous to oral therapy in the treatment of septic arthritis. J Pediatr Orthop. 2009;29:636–42.

    PubMed  Google Scholar 

  4. Basmaci R, Lorrot M, Bidet P, et al. Comparison of clinical and biologic features of Kingella kingae and Staphylococcus aureus arthritis at initial evaluation. Pediatr Infect Dis J. 2011;30:902–4.

    PubMed  Google Scholar 

  5. Bennett OM, Namnyak SS. Bone and joint manifestations of sickle cell anaemia. J Bone Joint Surg Br. 1990;72:494–9.

    CAS  PubMed  Google Scholar 

  6. Blickman JG, van Die CE, de Rooy JW. Current imaging concepts in pediatric osteomyelitis. Eur Radiol. 2004;14 Suppl 4:55–64.

    Google Scholar 

  7. Blyth MJ, Kincaid R, Craigen MA, et al. The changing epidemiology of acute and subacute osteomyelitis in children. J Bone Joint Surg Br. 2001;83:99–102.

    CAS  PubMed  Google Scholar 

  8. Bocchini C, Hulten K, Mason E, Gonzalez B, Hammerman W, Kaplan S. Panton-Valentine leukocidin genes are associated with enhanced inflammatory response and local disease in acute hematogenous Staphylococcus aureus osteomyelitis in children. Pediatrics. 2006;117:433–40.

    PubMed  Google Scholar 

  9. Butbul-Aviel Y, Koren A, Halevy R, et al. Procalcitonin as a diagnostic aid in osteomyelitis and septic arthritis. Pediatr Emerg Care. 2005;21:828–32.

    PubMed  Google Scholar 

  10. Bynum Jr DK, Nunley JA, Goldner JL, et al. Pyogenic arthritis: emphasis on the need for surgical drainage of the infected joint. South Med J. 1982;75:1232.

    PubMed  Google Scholar 

  11. Carrillo-Marquez MA, Hulten KG, Hammerman W, Mason EO, Kaplan SL. USA300 is the predominant genotype causing Staphylococcus aureus septic arthritis in children. Pediatr Infect Dis J. 2009;28:1076–80.

    PubMed  Google Scholar 

  12. Cassiano Neves M, Campagnolo JL, Brito MJ, Gouveia CF. Diagnosis, treatment and outcome of septic arthritis in infancy and childhood. EFORT Instructional Lecture Book. Heidelberg: Springer; 2007.

    Google Scholar 

  13. Ceroni D, Cherkaoui A, Ferey S, Kaelin A, Schrenzel J. Kingella kingae osteoarticular infections in young children: clinical features and contribution of a new specific real-time PCR assay to the diagnosis. J Pediatr Orthop. 2010;30:301–4.

    PubMed  Google Scholar 

  14. Ceroni D, Cherkaoui A, Combescure C, Francois P, Kaelin A, Schrenzel J. Differentiating osteoarticular infections caused by Kingella kingae from those due to typical pathogens in young children. Pediatr Infect Dis J. 2011;30:906–9.

    PubMed  Google Scholar 

  15. Cohen R, Grimprel E. Pharmacokinetics and pharmacodynamics of antimicrobial therapy used in child osteoarticular infections. Arch Pediatr. 2007;14 Suppl 2:S122–7.

    PubMed  Google Scholar 

  16. Craigen MA, Watters J, Hackett JS. The changing epidemiology of osteomyelitis in children. J Bone Joint Surg Br. 1992;74:541–5.

    CAS  PubMed  Google Scholar 

  17. Darley ES, MacGowan AP. Antibiotic treatment of gram-positive bone and joint infections. J Antimicrob Chemother. 2004;53:928–35.

    CAS  PubMed  Google Scholar 

  18. Dartnell J, Ramachandran M, Katchburian M. Haematogenous acute and subacute paediatric osteomyelitis: a systematic review of the literature. J Bone Joint Surg Br. 2012;94-B:584–95.

    Google Scholar 

  19. DeAngelis NA, Busconi BD. Hip arthroscopy in the pediatric population. Clin Orthop. 2003;406:60–3.

    PubMed  Google Scholar 

  20. Dodwell ER. Osteomyelitis and septic arthritis in children: current concepts. Curr Opin Pediatr. 2013;25:58–63.

    CAS  PubMed  Google Scholar 

  21. Dohin B, Gillet Y, Kohler R, et al. Pediatric bone and joint infections caused by Panton-Valentine leukocidin-positive Staphylococcus aureus. Pediatr Infect Dis J. 2007;26:1042–8.

    PubMed  Google Scholar 

  22. Dubnov-Raz G, Scheuerman O, Chodick G, Finkelstein Y, Samra Z, Garty BZ. Invasive Kingella kingae infections in children: clinical and laboratory characteristics. Pediatrics. 2008;122:1305–9.

    PubMed  Google Scholar 

  23. Dunkle LM. Towards optimum management of serious focal infections: the model of suppurative arthritis. Pediatr Infect Dis J. 1989;8:195–6.

    CAS  PubMed  Google Scholar 

  24. El-Sayed AM. Treatment of early septic arthritis of the hip in children: comparison of results of open arthrotomy versus arthroscopic drainage. J Child Orthop. 2008;2:229–37.

    PubMed Central  PubMed  Google Scholar 

  25. Fabry G, Meire E. Septic arthritis of the hip in children: poor results after late and inadequate treatment. J Pediatr Orthop. 1983;3:461–6.

    CAS  PubMed  Google Scholar 

  26. Fitzgerald Jr RH, Kelly PJ, Snyder RJ, Washington II JA. Penetration of methicillin, oxacillin, and cephalothin into bone and synovial tissues. Antimicrob Agents Chemother. 1978;14:723–6.

    PubMed Central  PubMed  Google Scholar 

  27. Frank G, Mahoney HM, Eppes SC. Musculoskeletal infections in children. Pediatr Clin North Am. 2005;52:1083–106.

    PubMed  Google Scholar 

  28. Gafur OA, Copley LA, Hollmig ST, et al. The impact of the current epidemiology of pediatric musculoskeletal infection on evaluation and treatment guidelines. J Pediatr Orthop. 2008;28:778–85.

    Google Scholar 

  29. Gainor BJ. Instillation of continuous tube irrigation in the septic knee at arthroscopy. Clin Orthop. 1984;183:96.

    PubMed  Google Scholar 

  30. Gavilán MG, Lopez JB, Artola BS. Peculiarities of osteoarticular infections in children. Baillieres Best Pract Res Clin Rheumatol. 1999;13:77–94.

    PubMed  Google Scholar 

  31. Gillespie WJ. The epidemiology of acute haematogenous osteomyelitis of childhood. Int J Epidemiol. 1985;14:600–6.

    CAS  PubMed  Google Scholar 

  32. Givon U, Liberman B, Schindler A, Blankstein A, Ganel A. Treatment of septic arthritis of the hip joint by repeated ultrasound-guided aspirations. J Pediatr Orthop. 2004;24:266–70.

    PubMed  Google Scholar 

  33. Goldenberg DL, Brandt KD, Cohen AS, et al. Treatment of septic arthritis: comparison of needle aspiration and surgery as initial modes of joint drainage. Arthritis Rheum. 1975;18(1):83–90.

    CAS  PubMed  Google Scholar 

  34. Goldstein WM, Gleason TF, Barmada R. A comparison between arthrotomy and irrigation and multiple aspirations in the treatment of pyogenic arthritis: a histological study in a rabbit model. Orthopedics. 1983;6:1309.

    Google Scholar 

  35. Gordon JE, Huang M, Dobbs M, et al. Causes of false-negative ultrasound scans in the diagnosis of septic arthritis of the hip in children. J Pediatr Orthop. 2002;22:312–16.

    PubMed  Google Scholar 

  36. Gracía-Arias M, Balsa A, Mola EM. Septic arthritis. Best Pract Res Clin Rheumatol. 2011;25:407–21.

    Google Scholar 

  37. Grimprel E, Lorrot M, Haas H, et al. Osteoarticular infections: clinical studies. Arch Pediatr. 2008;15 Suppl 2:S68–73.

    PubMed  Google Scholar 

  38. Grimprel E, Lorrot M, Haas H, et al. Osteoarticular infections: therapeutic proposals of the Paediatric Infectious Diseases Group of the French Society of Paediatrics (GPIP). Arch Pediatr. 2008;15 Suppl 2:S74–80.

    PubMed  Google Scholar 

  39. Gutierrez K. Bone and joint infections in children. Pediatr Clin North Am. 2005;52:779–94.

    PubMed  Google Scholar 

  40. Ho G. How best to drain an infected joint: will we ever know for certain? J Rheumatol. 1993;20:2001–3.

    PubMed  Google Scholar 

  41. Howard AW, Viskontas D, Sabbagh C. Reduction in osteomyelitis and septic arthritis related to Haemophilus influenzae type B vaccination. J Pediatr Orthop. 1999;19:705–9.

    CAS  PubMed  Google Scholar 

  42. Ivey M, Clark R. Arthroscopic debridement of the knee for septic arthritis. Clin Orthop. 1985;199:201–6.

    PubMed  Google Scholar 

  43. Jaberi FM, Shahcheraghi GH, Ahadzadeh M. Short-term intravenous antibiotic treatment of acute hematogenous bone and joint infection in children: a prospective randomized trial. J Pediatr Orthop. 2002;22:317–20.

    CAS  PubMed  Google Scholar 

  44. Jackson MA, Nelson JD. Etiology and medical management of acute suppurative bone and joint infections in pediatric patients. J Pediatr Orthop. 1982;2:313–23.

    CAS  PubMed  Google Scholar 

  45. Jagodzinski NA, Kanwar R, Graham K, Bache CE. Prospective evaluation of a shortened regimen of treatment for acute osteomyelitis and septic arthritis in children. J Pediatr Orthop. 2009;29:518–25.

    PubMed  Google Scholar 

  46. Ross JJ. Septic arthritis. Infect Dis Clin North Am. 2005;19:799–817.

    PubMed  Google Scholar 

  47. Journeau P, Wein F, Popkov D, Philippe R, Haumont T, Lascombes P. Hip septic arthritis in children: assessment of treatment using needle aspiration/irrigation. Orthop Traumatol Surg Res. 2011;97:308–13.

    CAS  PubMed  Google Scholar 

  48. Kallio MJ, Unkila-Kallio L, Aalto K, et al. Serum C-reactive protein, erythrocyte sedimentation rate, and white blood cell count in septic arthritis in children. Pediatr Infect Dis J. 1997;16:411–13.

    CAS  PubMed  Google Scholar 

  49. Kaplan S, Hulten K, Gonzalez B, et al. Three-year surveillance of community-acquired Staphylococcus aureus infections in children. Clin Infect Dis. 2005;40:1785–91.

    PubMed  Google Scholar 

  50. Khachatourians AG, Patzakis MJ, Roidis N, et al. Laboratory monitoring in pediatric acute osteomyelitis and septic arthritis. Clin Orthop Relat Res. 2003;409:186–94.

    PubMed  Google Scholar 

  51. Kocher MS, Mandiga R, Zurakowski D, et al. Validation of a clinical prediction rule for the differentiation between septic arthritis and transient synovitis of the hip in children. J Bone Joint Surg Am. 2004;86:1629–35.

    PubMed  Google Scholar 

  52. Kocher MS, Lee B, Dolan M, et al. Pediatric orthopedic infections. Early detection and treatment. Pediatr Ann. 2006;35:112–22.

    PubMed  Google Scholar 

  53. Krogstad P. Septic arthritis. In: Feigin RD, editor. Textbook of pediatric infectious diseases. 6th ed. Philadelphia: Saunders Elsevier; 2009. p. 742–8.

    Google Scholar 

  54. Lazzarini L, Lipsky BA, Mader JT. Antibiotic treatment of osteomyelitis: what have we learned from 30 years of clinical trials? Int J Infect Dis. 2005;9:127–38.

    CAS  PubMed  Google Scholar 

  55. Le Mont RL, Anderson PA, Dajani AS, et al. Acute hematogenous osteomyelitis in children. J Pediatr Orthop. 1987;7:579–83.

    Google Scholar 

  56. Lina G, Piemont Y, Godail-Gamot F, et al. Involvement of Panton-Valentine leukocidin-producing Staphylococcus aureus in primary skin infections and pneumonia. Clin Infect Dis. 1999;29:1128–32.

    CAS  PubMed  Google Scholar 

  57. Liu C, Bayer A, Cosgrove SE, et al. Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children: executive summary. Clin Infect Dis. 2011;52:285–92.

    PubMed  Google Scholar 

  58. Lorrot M, Doit C, Ilharreborde B, et al. Antibiotic therapy of bone and joint infections in children: recent changes. Arch Pediatr. 2011;18:1016–18.

    CAS  PubMed  Google Scholar 

  59. Lossos IS, Yossepowitch O, Kandel L, Yardeni D, Arber N. Septic arthritis of the glenohumeral joint: a report of 11 cases and review of the literature. Medicine. 1998;77:177–87.

    CAS  PubMed  Google Scholar 

  60. Lowy FD. Secrets of a superbug. Nat Med. 2007;13:1418–20.

    CAS  PubMed  Google Scholar 

  61. Manchanda V, Singh N. Laboratory diagnosis of osteoarticular infections in children. In: Agarwal A, Aggarwal AN, editors. Pediatric osteoarticular infections. New Delhi: Jaypee Brothers Medical Publisher; 2013.

    Google Scholar 

  62. McCarthy JJ, Dormans JP, Kozin SH, et al. Musculoskeletal infections in children: basic treatment principles, and recent advancements. Instr Course Lect. 2005;54:515–28.

    PubMed  Google Scholar 

  63. Mallet C, Ceroni D, Litzelmann E, et al. Unusually severe cases of Kingella kingae osteoarticular infections in children. Pediatr Infect Dis J. 2014;33(1):1–4.

    PubMed  Google Scholar 

  64. Martinez-Aguilar G, Avalos-Mishaan A, Hulten K, Hammerman W, Mason E, Kaplan S. Community-acquired, methicillin-resistant and methicillin-susceptible Staphylococcus aureus musculoskeletal infections in children. Pediatr Infect Dis J. 2004;23:701–6.

    PubMed  Google Scholar 

  65. Mathews CJ, Kingsley G, Field M, et al. Management of septic arthritis: a systematic review. Postgrad Med J. 2008;84:265–70.

    CAS  PubMed  Google Scholar 

  66. Maurin M. Real-time PCR as a diagnostic tool for bacterial diseases. Expert Rev Mol Diagn. 2012;12(7):731–75.

    CAS  PubMed  Google Scholar 

  67. Mera RM, Miller LA, Amrine-Madsen H, Sahm DF. Impact of new Clinical Laboratory Standards Institute Streptococcus pneumoniae penicillin susceptibility testing breakpoints on reported resistance changes over time. Microb Drug Resist. 2011;17:47–52.

    CAS  PubMed  Google Scholar 

  68. Morrey BF, Bianco AJ, Rhodes KH. Suppurative arthritis of the hip in children. J Bone Joint Surg Am. 1976;58-A:388–92.

    Google Scholar 

  69. Lynn MM, Mathews CJ. Advances in the management of bacterial septic arthritis. Int J Clin Rheumatol. 2012;7(3):335–42.

    CAS  Google Scholar 

  70. Nade S. Acute hematogenous osteomyelitis in infancy and childhood. J Bone Joint Surg Br. 1983;65:109–19.

    CAS  PubMed  Google Scholar 

  71. Nelson JD. Toward simple but safe management of osteomyelitis. Pediatrics. 1997;99:883–4.

    CAS  PubMed  Google Scholar 

  72. Nord KD, Dore D, Deeney VF, et al. Evaluation of treatment modalities for septic arthritis with histological grading and analysis of levels of uronic acid, neutral protease and interleukin-1. J Bone Joint Surg Am. 1995;77-A:258–65.

    Google Scholar 

  73. Otto M. Methicillin-resistant Staphylococcus aureus infection is associated with increased mortality. Future Microbiol. 2012;7:189–91.

    PubMed  Google Scholar 

  74. Pääkkönen M, Kallioa MTJ, Peltola H, Kallio PE. Pediatric septic hip with or without arthrotomy: retrospective analysis of 62 consecutive nonneonatal culture-positive cases. J Pediatr Orthop B. 2010;19(3):264–9.

    PubMed  Google Scholar 

  75. Pääkönen M, Kallio MJ, Kallio PE, et al. Sensitivity of erythrocyte sedimentation rate and C-reactive protein in childhood bone and joint infection. Clin Orthop Relat Res. 2010;468:861–6.

    Google Scholar 

  76. Pääkönen M, Peltola H. Antibiotic treatment for acute hematogenous osteomyelitis of childhood: moving to shorter courses and oral administration. Int J Antimicrob Agents. 2011;38:273–80.

    Google Scholar 

  77. Paakkonen M, Kallio PE, Kallio MJ, Peltola H. Management of osteoarticular infections caused by Staphylococcus aureus is similar to that of other etiologies: analysis of 199 staphylococcal bone and joint infections. Pediatr Infect Dis J. 2012;31:436–8.

    PubMed  Google Scholar 

  78. Paakkonen M, Peltola H. Management of a child with suspected acute septic arthritis. Arch Dis Child. 2012;97:287–92.

    CAS  PubMed  Google Scholar 

  79. Paakkonen M, Peltola H. Treatment of acute septic arthritis. Pediatr Infect Dis J. 2013;32:684–5.

    PubMed  Google Scholar 

  80. Paterson DC. Acute suppurative arthritis in infancy and childhood. J Bone Joint Surg Br. 1970;52-B:474–82.

    Google Scholar 

  81. Peltola H, Paakkonen M, Kallio P, Kallio MJ. Prospective, randomized trial of 10 days versus 30 days of antimicrobial treatment, including a short-term course of parenteral therapy, for childhood septic arthritis. Clin Infect Dis. 2009;48:1201–10.

    CAS  PubMed  Google Scholar 

  82. Peltola H, Paakkonen M, Kallio P, Kallio MJ. What is the appropriate treatment course for bacterial arthritis in children? Reply to Bradley. Clin Infect Dis. 2009;49:993.

    PubMed  Google Scholar 

  83. Peltola H, Paakkonen M, Kallio P, Kallio MJ. Clindamycin vs. first-generation cephalosporins for acute osteoarticular infections of childhood—a prospective quasi-randomized controlled trial. Clin Microbiol Infect. 2012;18:582–9.

    CAS  PubMed  Google Scholar 

  84. Petersen S, Knudsen FU, Andersen EA, Egeblad M. Acute haematogenous osteomyelitis and septic arthritis in childhood: a 10 year review and follow-up. Acta Orthop Scand. 1980;51:451–7.

    CAS  PubMed  Google Scholar 

  85. Pineda C, Nargas A, Rodriguez AV. Imaging of osteomyelitis: current concepts. Infect Dis Clin North Am. 2006;20:789–825.

    PubMed  Google Scholar 

  86. Ritz N, Curtis N. The role of Panton-Valentine leukocidin in Staphylococcus aureus musculoskeletal infections in children. Pediatr Infect Dis J. 2012;31:514–18.

    PubMed  Google Scholar 

  87. Roine I, Faingezicht I, Arguedas A, et al. Serial serum C-reactive protein to monitor recovery from acute hematogenous osteomyelitis in children. Pediatr Infect Dis J. 1995;14:40–4.

    CAS  PubMed  Google Scholar 

  88. Samilson RL, Bersani FA, Watkins MB. Acute suppurative arthritis in infants and children; the importance of early diagnosis and surgical drainage. Pediatrics. 1958;21:798–804.

    CAS  PubMed  Google Scholar 

  89. Sattar MA, Barrett SP, Cawley MI. Concentrations of some antibiotics in synovial fluid after oral administration, with special reference to antistaphylococcal activity. Ann Rheum Dis. 1983;42:67–74.

    CAS  PubMed Central  PubMed  Google Scholar 

  90. Schmidt D, Mubarak S, Gelberman R. Septic shoulders in children. J Pediatr Orthop. 1981;1:67–72.

    CAS  PubMed  Google Scholar 

  91. Schurman DJ, Smith RL. Surgical approach to the management of septic arthritis. Orthop Rev. 1987;16:75.

    Google Scholar 

  92. Shaw BA, Kasser JR. Acute septic arthritis in infancy and childhood. Clin Orthop. 1990;257:212–25.

    PubMed  Google Scholar 

  93. Shetty AK, Gedalia A. Septic arthritis in children. Rheum Dis Clin North Am. 1998;24:287–304.

    CAS  PubMed  Google Scholar 

  94. Smith SP, Thyoka M, Lavy CBD, Pitani A. Septic arthritis of the shoulder in children in Malawi: a randomized prospective study of aspiration versus arthrotomy and washout. J Bone Joint Surg Br. 2002;84-B:1167–72.

    Google Scholar 

  95. Sucato DJ, Schwend RM, Gillespie R. Septic arthritis of the hip in children. J Am Acad Orthop Surg. 1997;5:249–60.

    PubMed  Google Scholar 

  96. Tucson CE, Hoffman EB, Mann MD. Isotope bone scanning for acute osteomyelitis and septic arthritis in children. J Bone Joint Surg Br. 1994;76:306–10.

    Google Scholar 

  97. Verdier I, Gayet-Ageron A, Ploton C, et al. Contribution of a broad range polymerase chain reaction to the diagnosis of osteoarticular infections caused by Kingella kingae: description of twenty-four recent pediatric diagnoses. Pediatr Infect Dis J. 2005;24:692–6.

    PubMed  Google Scholar 

  98. Yagupsky P, Dagan R, Howard CW, Einhorn M, Kassis I, Simu A. High prevalence of Kingella kingae in joint fluid from children with septic arthritis revealed by the BACTEC blood culture system. J Clin Microbiol. 1992;30:1278–81.

    CAS  PubMed Central  PubMed  Google Scholar 

  99. Yagupsky P, Katz O, Peled N. Antibiotic susceptibility of Kingella kingae isolates from respiratory carriers and patients with invasive infections. J Antimicrob Chemother. 2001;47:191–3.

    CAS  PubMed  Google Scholar 

  100. Yagupsky P. Kingella kingae: from medical rarity to an emerging paediatric pathogen. Lancet Infect Dis. 2004;4:358–67.

    PubMed  Google Scholar 

  101. Yagupsky P, Porsch E, Joseph W. Kingella kingae: an emerging pathogen in young children. Pediatrics. 2011;127:557–65.

    PubMed  Google Scholar 

  102. Yagupsky P. Antibiotic susceptibility of Kingella kingae isolates from children with skeletal system infections. Pediatr Infect Dis J. 2012;31:212.

    PubMed  Google Scholar 

  103. Yang S, Ramachandran P, Hardick A, et al. Rapid PCR based diagnosis of septic arthritis by early Gram-type classification and pathogen identification. J Clin Microbiol. 2008;46:386–90.

    Google Scholar 

  104. Weston VC, Jones AC, Bradburry N, et al. Clinical features and outcome of septic arthritis in a single UK Health District 1982-1991. Ann Rheum Dis. 1999;58:214–19.

    CAS  PubMed Central  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedics, Hospital CUF Descobertas, Rua Mario Botas, Lisbon, 1998-018, Portugal

    Manuel Cassiano Neves MD, MSc

  2. Infecciology Unit, Pediatric Department, Hospital Dona Estefânia, CHLC-EPE, R. Jacinta Marto, Lisbon, 1169-045, Portugal

    Catarina Gouveia MD & Maria Joao Brito MD

  3. Department of Clinical Pathology, Microbiology Laboratory, Centro de Medicina Laboratorial Dr. Germano de Sousa, Hospital CUF Descobertas, Rua Mario Botas, Lisbon, 1998-018, Portugal

    Maria Favila Menezes MD

  4. Department of Orthopaedics, S Jose Hospital, CHLC-EPE, Rua José Antônio Serrano, Lisbon, 1150-199, Portugal

    Pedro Falcão MD

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  1. Manuel Cassiano Neves MD, MSc
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  2. Catarina Gouveia MD
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  3. Maria Joao Brito MD
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Correspondence to Manuel Cassiano Neves MD, MSc .

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    George Bentley

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Neves, M.C., Gouveia, C., Brito, M.J., Menezes, M.F., Falcão, P. (2014). New Trends in the Management of Osteo-articular Infections in Children. In: Bentley, G. (eds) European Instructional Lectures. European Instructional Lectures, vol 14. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54030-1_9

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