SOFT-TISSUE AND BONE-INFECTIONS FROM PUNCTURE WOUNDS IN CHILDREN

We report on the prevalence of osteomyelitis, the prevalence of soft t issue infections, and the type and number of pathogens encountered in bone and sogt tissue infections caused by puncture wounds in children. In addition, we seek to establish whether shoe gear plays a role in t he flora in infected puncture wounds and if laboratory indices are ind icative of the presence of infection. The group consisted of 44 nondia betic children admitted to hospital for puncture wounds of the foot. C ultures were positive for osteomyelitis in 7 patients (16%), all invol ving the forefoot (P<.04). The most common pathogen in soft tissue inf ections was Staphylococcus aureus. The most common pathogen in osteomy elitis was Pseudomonos aeruginosa. There was no significant difference in the prevalence of osteomyelitis and soft tissue infection based on footwear. There were no cases of osteomyelitis encountered among bare foot children (P<.04). In 10 cases (83%), P aeruginosa infection (both soft tissue and bone) occurred while the patients were wearing tennis shoes (P<.04). In this study, the leukocyte count (normal in 29 patie nts [66%]), erythrocyte sedimentation rate (normal in 28 patients [64% ]), and temperature (normal in 44 patients [95%]) did not have any pre dictive value in differentiating soft tissue infection from osteomyeli tis in children.