Osteomyelitis in Children

Acute osteomyelitis is an infection in the bone. It develops over a short time, usually about 2 weeks. In children, osteomyelitis is more common in the long bones of the arms and legs; however, it can affect any bone in the body. Osteomyelitis can happen in children of any age. About half of the time, it happens in children younger than 5 years old. Boys are more likely to get osteomyelitis than girls.

Osteomyelitis happens when a bacterial infection from another part of the body spreads to the bone. In children, an infection in the blood is a common cause of osteomyelitis. This is because a child's growing bones have an increased blood supply. That makes it easier for the bacteria to get into the bone. An infection from nearby soft tissue or a wound may also lead to osteomyelitis. Open fractures, where the skin over the broken bone is also damaged, have a high likelihood of developing into osteomyelitis.

In children, the bacteria that most often cause osteomyelitis is Staphylococcus aureus or "Staph."

These are common symptoms of osteomyelitis:

• Fever
• Fussiness or grouchiness
• Tiredness
• The following may happen in the area of the infected bone:
  • Soreness or pain
  • Not using the affected arm, leg, or other part of the body
  • Swelling
  • Redness

Get medical care right away if you think your child has osteomyelitis. Some of these symptoms may be caused by other health problems. Always talk with your child's healthcare provider for a diagnosis.

The sudden development of symptoms and the physical exam are key to diagnosing osteomyelitis.

Your child may have the following tests:

• Blood culture. A blood sample is checked for bacteria.
• Blood tests. Some abnormal results mean there is an infection in the body.
• Imaging tests. X-rays, a bone scan, and an MRI may be done.
• Bone biopsy. A sample of bone is taken and checked for bacteria.

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on the bacteria causing it and how severe the condition is.

Your child will likely be treated by specialists. They will be given antibiotics. These will first be given through an IV (intravenous) line into a vein. Your child will have IV medicines for at least a few days. In some cases, this is done for a few weeks. This is often followed by several weeks of antibiotics taken by mouth (oral). Other treatments will be given to ease the pain or manage fever. Surgery to remove infected tissue may be done. But this is rare for children.

Most of the time, antibiotics get rid of the infection. The infection can become long-term or chronic, but that's not common in children.

Call the healthcare provider if your child has any of the following:

• Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider
• Fussiness or grouchiness
• Tiredness

Also call the healthcare provider if your child has any of these in the area of the infection:

• Soreness or pain
• Not using that part of the body
• Swelling
• Redness

• Osteomyelitis is an infection in the bone.
• In children, it's more common in the long bones.
• In children, it is often from a blood infection.
• Antibiotics are used to treat osteomyelitis.
• In rare cases, surgery is needed.

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also, write down any new instructions your healthcare provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also, know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s healthcare provider after office hours. This is important if your child becomes ill and you have questions or need advice.