Osteomyelitis in Children

What is osteomyelitis?

Osteomyelitis is an infection in the bone. Infection is more common in the long bones of the body, but it can affect any bone in the body. Osteomyelitis can occur in children of any age, but is more common in premature infants and babies born with complications since their immune systems may not be fully developed.

What causes osteomyelitis?

Many different types of bacteria can cause osteomyelitis. The most common type of bacteria is called Staphylococcus aureus. Fungi can also cause osteomyelitis. The bacteria and fungi can enter the body in a variety of ways including, but not limited to, the following:

  • Infected wounds

  • Open fractures in which broken bones penetrate through the skin

  • Foreign object penetrating the skin

  • Infected joints

  • Infection that spreads from another source inside the body, such as ear infections

  • Trauma

What are the symptoms of osteomyelitis?

The following are the most common symptoms of osteomyelitis. However, each child may experience symptoms differently. Symptoms may include:

  • Tenderness or pain in the infected area

  • The child may have limited use or may not use the infected extremity at all

  • The child typically will guard or protect this area from being touched or seen

  • Swelling in the infected area

  • Redness in the infected area

  • Warmth around the infected area

  • Fever

It is important to seek medical attention immediately if osteomyelitis is suspected. The symptoms of osteomyelitis may resemble other conditions or medical problems. Always consult your child's doctor for a diagnosis.

How is osteomyelitis diagnosed?

The doctor makes the diagnosis of osteomyelitis with a complete medical history of the child, physical examination, and diagnostic tests. The doctor obtains a complete prenatal and birth history of the child and asks if the child has any recent colds or other infections.

Diagnostic procedures may include:

  • X-rays. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

  • Bone scans. A nuclear imaging method to evaluate any degenerative and/or arthritic changes in the joints; to detect bone diseases and tumors; to determine the cause of bone pain or inflammation.

  • Blood tests

Treatment of osteomyelitis

Specific treatment for osteomyelitis will be determined by your child's doctor based on:

  • Your child's age, overall health, and medical history

  • The extent of the condition

  • Your child's tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the condition

  • Your opinion or preference

The goal of treatment is to relieve the pain and completely treat the infection. Treatment may include one, or a combination, of the following:

  • Antibiotics to fight the infection

  • Pain medications

  • Surgery to clean out the infected area in and around the bone

Long-term outlook for a child with osteomyelitis

In most cases, the infection is cured with antibiotic medication. In severe cases of osteomyelitis, the infection can be very destructive to the bone, surrounding muscles, tendons, and blood vessels, resulting in long-term or chronic infection. Amputation of the infected limb is rare.

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