Les Infections Ostéoarticulaires de l’Enfant : Étude Rétrospective Monocentrique de 112 Cas Suivis au Centre Hospitalier Universitaire de Brazzaville (Congo)

RESUME Objectif. Rapporter les aspects epidemiologiques, cliniques et diagnostiques des infections osteoarticulaires de l’enfant a Brazzaville. Patients et Methodes. suivis du 1 er janvier 2015 au 31 decembre 2018, au sein de la filiere de soins « os-articulation et infection de l’enfant » (OARTI) du CHU de Brazzaville.  Le diagnostic d’infection osteoarticulaire (IOA) a ete retenu sur la base des criteres de Waldvogel et al. Resultats. 112 enfants ont ete inclus, dont 64 garcons (57,2%) et 48 filles (42,8%). L’âge moyen etait de 7,33 +/- 5,27  ans (extremes de 22 jours a 16 ans). Le delai moyen de consultation etait de 12,6+/- 9,3 jours (extremes de 1 a 90 jours). La douleur etait le principal motif de consultation  (93,3 %). Elle etait accompagnee d’une  fievre dans 74,1 % des cas. La drepanocytose etait  le principal terrain de survenue (44,64 %). Le debut etait un pseudo-traumatisme dans 24,10%.  L’IOA interessait les membres inferieurs dans 81,2 % des cas. Elle touchait par ordre de frequence le genou (25,3%), le tibia (23%), le femur (19,8%) et la hanche (15,3%). L’examen bacteriologique du liquide de ponction, realisee dans 26 cas, a identifie un germe dans 9 cas ainsi repartis: staphylocoque dore  (7 cas), Klebsiella (1 cas) et streptocoque (1 cas). La radiographie standard, examen d’imagerie de premiere intention, etait normale chez 20 patients sur  les 112  (17,85%). Aucun patient n’a beneficie d’une imagerie en coupe (TDM/IRM).  Les 112 cas d’IOA correspondaient a 45 cas d’osteomyelite infectieuse,   44 cas d’arthrite septique et  23 cas d’osteoarthrite infectieuse. Conclusion. Les IOA predominent aux membres inferieurs. La drepanocytose en est le terrain de survenue principal et le staphylocoque le principal germe. ABSTRACT Objective . To report the epidemiological, clinical and diagnostic features of osteoarticular infections. Methods . This was a cross sectional study based on medical records of children followed from January 1st 2015 to December 31st 2018, in a special unit dedicated to pediatric bone infections at the University Teaching Hospital of Brazzaville.  The diagnosis of osteoarticular infection was bases on the criteria of Waldvogel.  Results. We included 112 children, 64 boys (57.2%) and 48 girls (42.8%). The average age was 7.33 +/- 5.27 years (extremes from 22 days to 16 years). The mean time delay before consultation was 12.6+/- 9.3 days (extreme from 1 to 90 days). Osteoarticular pain was the main reason for consultation (93.3%). It was associated to fever in 74.1% of cases. Sickle cell disease was the leading underlining condition (44.64%). Pseudo-trauma was the triggering condition in 24.10% of cases.  Lower limbs were affected in 81.2% of cases. The distribution of the site of infection was as follows:  knee (25.3%), tibia (23%), femur (19.8%) and hip (15.3%). It was multifocal in 16.1% of cases. The results of puncture performed in 26 cases identified 9 positive bacteriology specimens: staphylococcus aureus (7 cases), Klebsiella (1 case) and streptococcus (1 case). Standard radiography, first-line imaging examination, was normal in 20 patients out of 112 (17.85%). No cross-sectional imaging (CT/MRI) was performed.  The types of infections were as follows:  45 cases of infectious osteomyelitis, 44 cases of septic arthritis and 23 cases of osteoarthritis. Conclusion. Most osteoarticular infections of the child affect the lower limbs. Sickle cell disease is the main underlying condition and staphylococcus is the most common causative agent.