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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 will be referred to an orthopedist (doctor specializing in treating bone and joint problems) for evaluation and treatment.

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

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

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. 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 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 germ causing the infection.

  • Imaging tests such as a bone scan, CT scan, 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 usually takes place in the hospital. The treatment may include:

  • Intravenous or oral (by mouth) antibiotic or antifungal medicines

  • Pain medicine

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

Antibiotics may be given for 4 to 6 weeks. This can be done using a PICC line (peripherally introduced central catheter) at home.

Long-term concerns

Most children recover completely. Although rare, complications can occur. They include:

  • Blood clots

  • Growth problems

  • Abnormally shaped bones

  • Fractures

  • Joint stiffness

  • Death of bone tissue


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