Imaging diagnosis of probable osteomyelitis in a 9-month-old infant from prehistoric Brazil: A brief history of healthcare in ancient times

Álvaro M. Monge Calleja; Dany Coutinho-Nogueira; Anne Marie Pessis; Ana Solari

doi:10.24215/18536387e099

Autores/as

Álvaro M. Monge Calleja University of Coimbra, Portugal https://orcid.org/0000-0002-1719-7378
Dany Coutinho-Nogueira University of Coimbra, Portugal https://orcid.org/0000-0002-1760-165X
Anne Marie Pessis Instituto Nacional de Ciência e Tecnologia de Arqueologia, Paleontologia e Ambiente do Semiárido do Nordeste do Brasil, Brasil https://orcid.org/0000-0002-0925-7617
Ana Solari Instituto Nacional de Ciência e Tecnologia de Arqueologia, Paleontologia e Ambiente do Semiárido do Nordeste do Brasil, Brasil, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina https://orcid.org/0000-0001-5677-2868

DOI:

https://doi.org/10.24215/18536387e099

Palabras clave:

formación de hueso nuevo perióstico, enfermedad infecciosa, paleopatología de no-adultos

Resumen

El Individuo 9 (9 ± 3 meses) del sitio Toca do Enoque, Holoceno medio (6650-6170 años AP), en Piauí, Brasil, mostró cambios óseos patológicos significativos y recibió un tratamiento mortuorio excepcional. Estudios previos infirieron cuidados de salud especiales, aunque el diagnóstico diferencial fue indefinido. Este estudio reexamina el diagnóstico patológico utilizando radiografías, tomografías y reconstrucciones 3D de 10 huesos largos. Los cambios patológicos incluyeron crecimientos óseos endocraneales y formación de hueso nuevo perióstico poliostótico, bilateral y asimétrico que afectó a huesos largos y costillas. La tibia derecha mostró deformidad anteromedial y perforaciones de adentro hacia afuera con bordes dentados y rebabas. Las imágenes revelaron líneas de Harris en el húmero izquierdo, proliferación ósea endóstica en tibias, húmeros y radio derecho, y pérdida de densidad cortical en la tibia derecha. Una conexión entre los espacios medular, subperióstico y externo sugirió características de cloacas o abscesos. Los cambios en la tibia sugieren involucro sin signos de secuestros, consistente con osteomielitis neonatal/infantil aguda hematógena. Aunque extremadamente rara, la cloaca puede surgir a edades tempranas en circunstancias específicas. Los retrasos en la evacuación de pus, la lactancia materna, la resiliencia y los cuidados de salud, pueden haber prolongado la vida del Individuo 9 y agravado la duración de la infección. Este posible caso de osteomielitis neonatal/infantil es raro y valioso, potencialmente el más joven documentado en paleopatología y el primero en América. Sin embargo, las lesiones costales y endocraneales inespecíficas no descartan comorbilidades. Ampliar el corpus de estudios de casos es esencial para refinar los diagnósticos en bioarqueología y paleopatología.

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