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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. A child with osteomyelitis may be referred to an orthopedist (doctor specializing in treating bone and joint problems) for evaluation.

Front view cross section of hip joint showing infection in leg bone.

What are the causes of osteomyelitis?

Children with no spleen, children who are on dialysis, children with sickle cell disease, or children who have diabetes are at higher risk of a bone infection. But any child can develop this infection. Common causes include:

  • Infection of another part of the body (such as strep throat) that moves to the bone through the blood

  • Injury to the bone that is open to the air (such as an open or “compound” fracture), which allows germs to enter

  • A cut, scrape, or puncture that gets infected

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 over 101.5°F

  • Pain in the bone

  • Swelling of the limbs

  • Redness or warmth of the skin on the limb

  • Pus draining from the skin

  • Not letting the limb be touched

  • Not using the limb (limb unable to hold weight)

How is osteomyelitis diagnosed?

If osteomyelitis is suspected:

  • An X-ray is taken of the area to look for infection.

  • A sample of blood is taken and tests done to confirm infection and determine the infecting organism.

  • Imaging tests such as a bone scan, CT (computed tomography) scan, magnetic resonance imaging (MRI), or ultrasound may be done.

  • A biopsy (procedure to take a sample of bone) may be done. This helps find the germ causing the infection.

How is osteomyelitis treated?

Treatment is done in the hospital. If your child was not in the hospital before being diagnosed, he or she will be admitted shortly after diagnosis. Once treatment is started, though, it might be continued at home. Discuss this with your healthcare provider. The treatment may include:

  • Medications (antibiotics or antifungals) to kill germs. These are given by intravenous (IV) line or by mouth.

  • Pain medications. These help make the child more comfortable.

  • Drainage of an abscess (pus around the infection).

  • Immobilization of the affected bone and nearby joints (bracing or strapping to keep the limb still). This is done until the infection is controlled. It helps keep the infection from spreading.

  • Surgery to remove infected tissue. This allows healthy tissue to heal.

What are the long-term concerns?

Once treated, osteomyelitis usually does not cause long-term problems. If not treated, the infection can become chronic (long-term and hard to treat). Death of bone tissue may result.

 

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