Analysis of the influence of Ascaris, Borrelia, Toxocara, Toxoplasma and Mycoplasma infections on the incidence and course of Perthes disease - pilot study.

BACKGROUND It is known from medical literature that such organisms as Ascaris, Borrelia, Mycoplasma, Toxocara and Toxoplasma can cause arthritis or cause vascular changes. We studied their influence on the incidence, course and outcome of Perthes disease. MATERIALS AND METHODS Sixty-one patients treated for Perthes disease were analysed. Thirty-seven of them took part in a follow-up examination after a mean of 2.8 years post first admission. A control group consisted of 22 patients treated operatively for other reasons. Blood tests, radiographic studies and a physical examination were carried out during the first admission and the follow-up visit. RESULTS Serologic tests were positive for at least one pathogen in 67.2% of the patients with Perthes disease. In the control group, the tests were positive for Borrelia in 52.2% of the patients and for Mycoplasma in 40.9%, compared to antibody rates of 17.1% and 29.3%, respectively, in the group with Perthes disease. The lack of statistically significant differences in the distribution of infected vs. not-infected children according to the Herring classification suggests the absence of influence of the pathogens on the radiographic severity of Perthes disease. There were no statistically significant differences in the range of internal rotation and abduction of the affected limb between patients with negative and positive blood tests. The radiographs failed to show statistically significant differences in the structure of proximal femur between infected and non-infected children. CONCLUSIONS Patients with a diagnosis of Perthes disease did not demonstrate more frequent infection with the organisms investigated than the control group. No link was found between those infestations and the course and prognosis of Perthes disease.