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Musculoskeletal infections around the hip and pelvis are relatively uncommon. Th
ese have historically been
treated successfully with antibiotic therapy alone in the absence of septic arthritis or frank collections. Th
e advent of more
aggressive organisms with new virulence factors has led to life-threatening pelvic pyomyositis despite antibiotic treatment in
the otherwise healthy child.
To review all cases of musculoskeletal pelvic infections over a 6 month period to establish whether prognostic
indicators can be identifi
ed to predict rapid deterioration /multiorgan involvement.
All primary infections at
Westmead children�s hospital over a 6 month period. Only cases involving the pelvic girdle
were included; septic arthritis of the hip was excluded as were secondary infections and hardware related infections. Initial
presentation, physical examination and emergency investigations were critically evaluated to diff
erentiate patients likely to
: 9 cases of deep pelvic girdle infections were identifi
ed. Of these 3 patients developed multiorgan failure requiring
varying amounts of invasive supportive care. Th
e initial WCC trends and procalcitonin levels were suggestive of rapid
deterioration. Infection with community acquired MRSA was also associated with a poor outcome.
: Deep pelvic infections in adolescents and children can be life-threatening. Early commencement of appropriate
antibiotics before positive cultures may be benefi
cial. Very high procalcitonin and low WCC are associated with the poorest
Dr. Chris Phoon completed undergraduate studies at the University of NSW and has been working in the fi eld of orthopaedic surgery since 2005. He is a member of the Royal Australasian College of Surgeons and the Australian Orthopaedic Association.
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