Osteoarticular Infections in Newborns: Prognostic Factors and Outcome

Purpose: To analyze clinical, laboratory, microbiologic, imaging and therapeutic data that contribute to outcome in newborn infants with osteoarticular (OSA) infection. Methods: Clinical course, imaging and follow-up data of 15 newborns with the diagnosis of OSA infection were retrospectively reviewed. Results: 15 newborns with 23 acute osteoarthritis foci were included: risk factors were identified in 73%, lower extremities were affected in 8 (53%) and more than half of the children had two-or multifocal involvement. The predominant causative agent was Staphylococcus aureus. While plain radiography showed osteolytic bone lesions in only 33%, scintigraphy was consistent with osteomyelitis in 74% of study infants. Magnetic resonance imaging revealed an inflammatory process even when other imaging modalities did not detect any OSA signs. All newborns underwent surgical and antibiotic treatment; the average time from admission to surgical treatment was 3.6 days. No bone and joint deformities or limb-length disturbances were found in the mean follow-up period of 8.5 years. Conclusion: Our study confirms that the most important prognostic factors in predicting a long-term favorable outcome are early diagnosis and therapy consisting of a combination of both surgical and appropriate antibiotic treatment.