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Osteomyelitis, Pediatric

Blanca E. Gonzalez, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Infection of any bone

  • Most commonly occurs in the metaphysis of a long bone (especially the distal femur or proximal tibia)

EPIDEMIOLOGY

  • One of the most common invasive bacterial infect...

DIAGNOSIS

HISTORY

  • Persistent, increasing pain and tenderness over the affected bone

  • Restricted use of the involved limb (pseudoparalysis may be the only sign in a neonate), refusal to bear weight, or li...

TREATMENT

MEDICATION

  • Empiric antibiotics should cover the most likely pathogens considering patient age, history of presentation, physical findings, and underlying medical conditions.

  • Empiric therapy sh...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Most children who receive appropriate treatment have no long-term sequelae.

  • Inflammatory markers (ESR and CRP) are typically measured serially until they normalize...

ADDITIONAL READING

  • Arnold JC, Cannavino CR, Ross MK, et al. Acute bacterial osteoarticular infections: eight-year analysis of C-reactive protein for oral step-down therapy. Pediatrics.  2012;130(...

CODES

ICD9

  • 730.20 Unspecified osteomyelitis, site unspecified

  • 730.00 Acute osteomyelitis, site unspecified

  • 730.10 Chronic osteomyelitis, site unspecified

  • 730.25 Unspecified osteomyelitis, pelvic region an...

FAQ

  • Q: Can children with osteomyelitis present without fever and with normal CBCs and inflammatory markers?

  • A: Fever along with leukocytosis and elevated inflammatory markers (CRP and ESR) are common i...

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