When Your Child Has Osteomyelitis
Your child has been diagnosed with osteomyelitis. This is an infection of a bone by a germ (bacteria or fungus). In children, infection in the long bones of the arms and legs are most common. Your child may be referred to an orthopedist (specialist in bone and joint problems) or an infectious disease specialist (specialist in infections) for evaluation and treatment.
What causes osteomyelitis?
Germs such as bacteria and fungi can cause osteomyelitis. The most common type of bacteria that causes osteomyelitis is called Staphylococcus aureus or staph. The bacteria and fungi can enter the body through:
Infected wounds or joints
Infections that spread from another part of the body
Broken bones that break through the skin
Foreign object that breaks the skin
Those at higher risk for bone infection include children:
With no spleen
Who are on dialysis
With sickle cell disease
Being treated with immunosuppressive drugs (such as chemotherapy)
Who have diabetes
But any child can develop this infection. In some cases, the cause of the infection is never known.
What are the signs and symptoms of osteomyelitis?
If your child has any of these signs or symptoms, get medical help right away.
Fever of 100.4°F (38°C) or higher, or as directed by your child's healthcare provider
Pain in the bone
Swelling of the arms or legs
Redness or warmth of the skin on the arms or legs
Pus draining from the skin
Not letting the arms or legs be touched
Not using the arms or legs (limb unable to hold weight)
How is osteomyelitis diagnosed?
If your doctor thinks your child may have osteomyelitis, these tests may be done:
X-ray of the area to look for infection
Blood tests to confirm infection and determine the germ causing the infection
Imaging tests such as a bone scan, CT scan, MRI, or ultrasound
Biopsy (procedure to take a sample of bone) to find the germ causing the infection
How is osteomyelitis treated?
At first, treatment usually takes place in the hospital. The treatment may include:
Antibiotic or antifungal medicines intravenously (IV) or oral
Surgery to clean out infected area in and around the bone
Your child may be given antibiotics for 4 to 6 weeks. This can be done using a PICC line (peripherally introduced central catheter) at home. In other cases, your child may be able to transition to oral antibiotics depending on how your child has responded and the specific germ causing the infection.
Most children recover completely. Although rare, complications can occur. They include:
Abnormally shaped bones
Death of bone tissue
November 06, 2017
Fraimow, HS. Systemic Antimicrobial Therapy in Osteomyelitis. Seminars in Plastic Surgey (2009); 23(2); pp: s90-s99s, Liu, C. Guidelines for the Treatment of MRSA Infections in Adults and Children. Clinical Infectioius Diseases Advance Acess (2011); 52; pp. s1-s38
Adler, Liora, C., MD,Bass, Pat F., III, MD, MPH