ACUTE HEMATOGENOUS OSTEOMYELITIS

Abstract
One-hundred cases of acute hematogenous seen at the Hospital for Sick Children in a 40-month period from January, 1956, to June, 1958, have been reviewed. These patients were treated on all services of the hospital (pediatric, general surgical, and orthopaedic). In the 68 cases in which positive cultures were obtained, nearly 50% were staphylococcus pyogenes, either partially or wholly resistant to penicillin. For this reason it was felt that antibiotic therapy should begin with a broad spectrum antibiotic (or on the basis of recent experience, methycillin). The best chance for aborting and controlling the disease conservatively comes in the first 3 days following the onset of symptoms. For this reason, early accurate diagnosis is urged, and prompt, effective treatment is necessary. Emphasis is laid on the fact that the diagnosis must be made on clinical, not x-ray, findings. On the basis of the recent literature and the findings in this series, a rational scheme of therapy for acute hematogenous osteomyelitis has been suggested.

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