• Pediatric Infection and Vaccine
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• v.18 no.1
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• pp.31-39
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• 2011

Purpose : This study was performed for the purpose of finding causative organisms and clinical features of septic arthritis or acute osteomyelitis in children. Methods : The study involved a retrospective review of the medical records of 63 microbiologically confirmed cases of acute pyogenic arthritis and osteomyelitis. All of the cases were brought about by community-associated infections and managed at the Seoul National University Children's Hospital or Seoul National University Bundang Hospital from June 2003 to July 2009. Results : The median age of all cases was 60 months and there were 35 males and 28 females. Major involved joints included the hip joint (15 cases), knee joint (7 cases), shoulder joint (4 cases), and elbow joint (4 cases). Also, major involved bones included the femur (20 cases), tibia (13 cases), humerus (7 cases), and radius (7 cases). Staphylococcus aureus was the most commonly identified causative organism, accounting for 49 cases (77.8%). Of the 49 isolates of S. aureus, methicillin-resistant S. aureus (MRSA) accounted for 8 cases (16.3%). Group B streptococcus spp. (GBS) and Salmonella spp. accounted for 3 cases, respectively. Nafcillin or cefazolin was often prescribed as an initial empirical antibiotic. There were 9 cases that were managed by a regimen that included vancomycin as the first choice. Fifty four cases (85.7%) recovered without any complications. Methicillin-sensitive S. aureus (MSSA), responsible for 41 cases, caused chronic complications in 3 cases. Of 8 cases caused by MRSA, 1 case showed chronic complication. There were no fatal cases. Conclusion : S. aureus remains the most common organism causing acute pyogenic arthritis and osteomyelitis of childhood acquired in the community. The high prevalence of methicillin resistance among S. aureus should be considered carefully in the selection of initial empirical antibiotics.

• Journal of Korean Foot and Ankle Society
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• v.3 no.1
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• pp.19-25
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• 1999

The purpose of this study Is to assess the retained range of motion[RROM] of the foot after arthrodesis of the ankle joint, which might help designing the angle of arthrodesis. We reviewed the results including the RROM in 14 cases of ankle arthrodesis. Underlying causes included trauma group(six posttraumatic arthritis) and disease group(three osteoarthritis, three Charcot joints, one chronic synovitis and one pyogenic arthritis). We measured the RROM on the lateral roentgenograms of the ankle in full dorsiflexion and plantarflexion, The results were assessed by the AOFAS hindfoot scale[score]. The RROM in sagittal plane was $23.4{\pm}5.3$ degrees and the score was 71.5 points on average. The RROM and the score were $26.8^{\circ}{\pm}2.1$, 81.2 points respectively in trauma group and $20.8^{\circ}{\pm}5.6$, 64.3 points in disease group; $26.6^{\circ}{\pm}2.3$, 83.4 points in cases younger than 40 years of age and $21.6^{\circ}{\pm}5.7$, 64.9 points in the older. The mean score was 77.3 points in cases whose RROM were $24^{\circ}$ or more and 61 points in cases of less RROM; 69.6 and 73.4 points in cases with and without adjacent degenerative arthritis respectively. The score was 69.7, 73.3 and 71.5 points in cases whose angle of arthrodesis was in dorsiflexion, neutral, plantarflexion respectively. In conclusion, after ankle arthrodesis RROM of the foot was $23.4^{\circ}$, and the more the RROM, the higher the score. In cases with sufficient amount of RROM, the angle of fusion on sagittal plane might not influence the result significantly.

• Clinics in Shoulder and Elbow
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• v.9 no.2
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• pp.242-245
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• 2006

Infection on sternoclavicular joint after electrical burn is rare. No case was reported previously in Korea. Even though the disease is rare, we treated the case successfully with intravenous antibiotics followed by curettage and drainage. Successful treatment was achieved in the case of infection on sternoclavicular joint after electrical burn.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.2
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• pp.222-230
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• 1991

Pyogenic orofacial infections are most commonly odontogenic in origin. Although such infections are usually self-limiting and spatially confined, purulent material may occasionally borrow deeply into contiguous fascial space or planes far from the initial site of involvement. The incidence of orofacial infection remains low in this modern era of preventive dental care and antibiotic therapy, but severe orofacial infections are most frequently observed in the medically compromised patients. We experienced 5 cases of severe orofacial odontogenic infection associated with medical diseases, and then concluded as follows : 1. The average hospitalized period was about 5 weeks, and the signs that indicated that the infections were controlled usually appeared in third week after incision and drainage. 2. The involved medical diseases were diabetes mellitus iatrogenic Cushing's syndrome, rheumatoid arthritis, malnutrition, etc. 3. The medical diseases should be treated coincidently with control of infection.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.167-174
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• 2012

Purpose: The purpose of this study is investigation of clinical and functional outcomes in homogeneous group with positive culture after arthroscopic management for pyogenic knee arthritis and analysis of factors affecting those outcomes. Materials and Methods: Thirty-two patients with positive culture after arthroscopic management were included. Mean follow-up period was 41.6 months. Clinical evaluation included death related to infection, recurrence, time to normalize erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), duration of administration of intravenous antibiotics and readmission. Radiographic evaluation was performed according to Kellgren and Lawrence. The prevalence of total knee arthroplasty was investigated and functional evaluation included modified Lysholm, Tegner activity and Korean version of the Western Ontario and McMaster Universities (K-WOMAC) score. Results: Staphylococcus aureus was identified in 21 patients. Time to normalize ESR and CRP was 78.0 and 67.6 days, respectively. Two patients died while there were six recurrences and five readmissions. Rate of recurrence was significantly high in patients with chronic renal failure (P=0.034) and incidence of readmission was associated with higher radiographic grade of osteoarthritis and rate of reoperation (P=0.032 and P=0.006, respectively). At the final follow-up, radiographic grade worsened in 21 patients and was associated with those at first visit. Five arthroplasties were performed. Average modified Lysholm score, Tegner activity score and K-WOMAC score were 53.5, 2.7, 44.2 points, respectively. Conclusion: The severity of osteoarthritis on final radiographs was associated with those at first visit. Patients with higher grade of osteoarthritis at first visit showed higher incidence of readmission and those with chronic renal failure demonstrated higher chances of recurrence.

• Clinical and Experimental Pediatrics
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• v.53 no.5
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• pp.653-656
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• 2010

$Listeria$ $monocytogenes$ is a facultative anaerobic, gram-positive bacillus that is isolated from the soil, vegetables, and wild or domestic animals. Listeria occurs predominantly in the elderly, immunocompromised patients, pregnant women and newborns. Infections by this microorganism are rare in healthy infants and children. $L.$ $monocytogenes$ may cause meningitis, meningoencephalitis, brain abscess, pyogenic arthritis, osteomyelitis, and liver abscesses in children. The course of meningoencephalitis by listeria is often severe and even fatal. Acute hydrocephalus can develop as a complication and the mortality associated with listeriosis is significantly high. We present a case of meningoencephalitis caused by $L.$ $monocytogenes$ in a previously healthy 7-year-old girl.

• The Journal of Korean Physical Therapy
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• v.7 no.1
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• pp.61-67
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• 1995

The silver cation has broad-spectrum antibiotic activity toward Gram-positive, Gram-negative, fungal. aerobic and anerobic micro-organisms. Silver has been used to care of infected wound. pyogenic arthritis, and chronic osteomyelitis. The purpose of this study was to determine whether pure silver wire iontophoresis using milliamperage direct current has an inhibitory effect on growth in vitro of 3 different species of bacteria-Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. Using agarose based media, silver iontophoresis performed at 0, 1, 2, 4, 8 mA for 15 minutes. All experiments were performed in triplicate. Following iontophoresis, inhibition zone width of bacterial growth was measured with calliper. The inhibition of bacterial growth occured at the anodal silver electrode. Inhibition zone width of bacterial growth was significantly increased in all three bacterial species (p<0.05). Between bacterial species, inhibition zone width was not significantly different. Inhibition gone and amperage showed a highly significant positive linear relationship (p<0.001). The result of this study showed that pure silver wire iontophoresis with milliamperage direct current, as well as microamperage direct current, can inhibit bacterial growth in vivo.

• Journal of Korean Foot and Ankle Society
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• v.1 no.1
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• pp.15-22
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• 1997

A variety of surgical approach for ankle and tibiotalocalcaneal arthrodesis has been described. We used a transfibular approach between the sural nerve and lateral branch of the superficial peroneal nerve. This permits excellent visualization of the ankle and subtalar joint so that the fusion can readily be achieved under the direct visualization. Eight ankle fusions and four tibiotalocalcaneal fusions were carried out through a transfibular approach and reviewed. The resected fibula was utilized for bone graft. The follow up period was from 12 to 22 months. Ages of the patients ranged from 27 to 58 years. The postoperative regimen was six weeks nonweight bearing in a short leg cast, followed by weight bearing in a short leg cast until union occurred. All cases were fused except one who had preoperative pyogenic arthritis of the ankle and hindfoot. The results were as follows; 1. The chance of incisional neuroma is lessened through incision between the sural nerve and superficial peroneal nerve. 2. The possibility of a skin slough is reduced by using full thickness skin flaps. 3. Excellent visualization of the ankle and subtalar joint is easily achieved. So, we believed that the transfibular approach for ankle and tibiotalocalcaneal arthrodesis is the excellent surgical approach.

• Neonatal Medicine
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• v.18 no.2
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• pp.288-292
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• 2011

Purpose: The incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection has increased in children and in neonates, and is particularly associated with frequent use of central venous catheter in very low birth weight (VLBW) infants. It is known that the morbidity and mortality of MRSA infection are low in neonates, as compared with adults. The objective of this study was to examine the difference in clinical characteristics between VLBW infants that survived and those that did not, a catheter-related bloodstream infection (CRBSI) of MRSA. Methods: Thirty-four VLBW infants had laboratory-confirmed bloodstream infection with S. aureus. We examined the incidence, mortality and morbidity of CRBSI, and predictive factors associated with mortality. Results: Twenty-six infants had same pathogen (24 MRSA, 2 Methicillin-sensitive Staphylococcus aureus) in the blood and in the catheter tip. Eight infants (25.8%) died in the CRBSI and they all had MRSA blood infections. Sex ratio, gestational age, duration between blood collection and identification of pathogens, and WBC and platelet count were not significantly different between patients that died from and patients that survived CRBSI of MRSA. C-reactive protein (CRP) was significantly higher in VLBW infants that died. Mean age of onset and hospital day was earlier (9.1${\pm}$6.6 vs. 26.9${\pm}$20.2; P=0.005) and shorter for patients that died (10.1${\pm}$7.0 vs. 73.0${\pm}$32.4; P=0.000). Two survivors had complications of pyogenic arthritis of the lower extremities and soft tissue infection, respectively. Conclusion: Mortality of CRBSI was likely to be high in VLBW infants and might be anticipated by CRP and early onset of disease.