Modern ideas about metaepiphyseal osteomyelitis. Review

Abstract

This paper presents a review of domestic and foreign literature on the issues of diagnosis and treatment of young children with metaepiphyseal osteomyelitis, the changes in the immune system and cytokine levels, and the targeted correction of the disorders that have arisen. This work aims to highlight modern approaches to the diagnosis and treatment of metaepiphyseal osteomyelitis in young children with emphasis on the changes in the immune status of the patient. Literary search was performed in the databases in Russian eLibrary.ru, English Medline, Web of Science, and PubMed using the following keywords: metaepiphyseal osteomyelitis, infants, immune system, cytokines, interleukins, and roncoleukin. A total of 405 papers were found, of which 66 were fully consistent with the purpose of our study and thus selected for the analysis. Results showed that the search for effective methods for the early diagnosis of the osteomyelitic process in young children continues to be relevant; no study has provided a complete picture of the severity of the pathological process. Although numerous studies have been performed, no consensus has been achieved in assessing the significance of changes in the parameters of the immune system and its cytokine link during the development of metaepiphyseal osteomyelitis. The data indicated a positive effect of the use of recombinant interleukin-2 in the complex treatment of a number of diseases, especially in young children with various pathological conditions. Metaepiphyseal osteomyelitis in young children is an urgent problem in pediatric surgery largely due to the increase in the number of children with reduced immuno-biological reactivity, which requires the use of effective immunocorrection agents as part of the complex etiotropic and pathogenetic treatment. This approach applies to such powerful means of immunocorrection as recombinant cytokine preparations.