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Klin Padiatr 2008; 220(6): 380-383
DOI: 10.1055/s-0028-1086030
Case Report

© Georg Thieme Verlag KG Stuttgart · New York

A Novel Element in the Management of Chronic Granulomatous Disease (CGD)? – Treatment of Osteomyelitis with Additional Hyperbaric Oxygen Therapy (HBO)

Ein neues Element bei der Behandlung der septischen Granulomatose (CGD)? – Die Behandlung der Osteomyelitis mit zusätzlicher hyperbarer Sauerstofftherapie (HBO)K. Beltz 1 , 2 , A. Christaras 3 , A. Kovacevic 4 , J. Schaper 5 , H. Strelow 3 , T. Niehues 1 , 2
  • 1Children's Hospital, HELIOS Klinikum Krefeld, Germany
  • 2Department of Pediatric Oncology, Hematology and Clinical Immunology, University Hospital Düsseldorf, Germany
  • 3Hyperbaric Oxygen Division, Department of Trauma and Hand Surgery, University Hospital Düsseldorf, Germany
  • 4Department of Pediatric Cardiology and Pneumology, University Hospital Düsseldorf, Germany
  • 5Institute for Diagnostic Radiology, Duesseldorf Children's Hospital, University Hospital Düsseldorf, Germany
Further Information

Publication History

Publication Date:
23 October 2008 (online)

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Abstract

Chronic granulomatous disease (CGD) is caused by malfunctioning of the phagocyte NADPH oxidase responsible for the generation of microbicidal reactive oxygen species. It is characterized by severe recurrent infections with catalase positive bacteria. Bacterial or fungal osteomyelitis is a common complication which often does not respond sufficiently to intravenous antibiotic treatment. We report the case of a four year old boy with CGD and osteomyelitis of the mandible refractory to intravenous antibiotic therapy. Introduction of hyperbaric oxygen therapy (HBO) was well tolerated and led to resolution of the osteomyelitis.

Zusammenfassung

Die septische Granulomatose wird durch einen Defekt in der Phagozyten-NADPH-Oxidase verursacht, die für die Produktion antimikrobieller Sauerstoffradikale verantwortlich ist. Die septische Granulomatose ist durch schwere rekurrierende Infektionen durch katalase-positive Bakterien charakterisiert. Osteomyelitiden durch Bakterien oder Pilze sind eine häufige Komplikation, welche oft nicht hinreichend auf eine intravenöse antibiotische Therapie ansprechen. Wir berichten über einen vierjährigen Jungen mit septischer Granulomatose und einer Antibiotika-refraktären Osteomyelitis der Mandibula. Der Einsatz der hyperbaren Sauerstofftherapie wurde vom Patienten gut vertragen und führte zu einer eindrucksvollen Befundbesserung.

Key words

hyperbaric oxygen therapy - refractory osteomyelitis - chronic granulomatous disease

Schlüsselwörter

hyperbare Sauerstofftherapie - therapierefraktäre Osteomyelitis - septische Granulomatose

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Correspondence

Tim NiehuesMD 

Lutherplatz 40

47805 Krefeld

Germany

Phone: +49/2151/32 23 01

Fax: +49/2151/32 23 34

Email: tim.niehues@helios-kliniken.de

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