Osteomyelitis in Children

What is acute 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. But 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 under 5 years of age.

What causes acute osteomyelitis in a child?

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 from a wound may also lead to osteomyelitis.

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

What are the symptoms of osteomyelitis in a child?

These are common symptoms of osteomyelitis:

  • Fever

  • Fussiness or irritability

  • Tiredness

  • The following may happen in the area of the infected bone:

    • Tenderness or pain

    • Not using the affected arm, leg or other part of the body

    • Swelling

    • Redness

     

Seek medical attention right away if you think your child has osteomyelitis. The symptoms of osteomyelitis may look like other conditions or health problems. Always talk with your child's healthcare provider for a diagnosis.

How is osteomyelitis diagnosed in a child?

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.

  • Bone biopsy. A sample of bone is taken and checked for bacteria.

  • Imaging tests. X-rays, a bone scan, and an MRI may be done.

How is osteomyelitis treated in a child?

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

Your child will probably be treated by one or more specialists. He or she will be given antibiotics. First into a vein (IV) for at least several days, although sometimes treatment will include several weeks of IV medicines. This is often followed by several weeks of oral antibiotics. Other treatment will be given to ease pain. Surgery to remove infected tissue may be done. But this is uncommon in children.

What are possible complications of osteomyelitis in a child?

Most of the time, antibiotic therapy gets rid of the infection. Although not common in children, the infection can become long-term or chronic.

When should I call my child's healthcare provider?

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

  • Fever

  • Fussiness or irritability

  • Tiredness

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

  • Tenderness or pain

  • Not using that part of the body

  • Swelling

  • Redness

Key points about osteomyelitis in children

  • 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.

  • Rarely, surgery is needed.

Next steps

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 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 provider after office hours. This is important if your child becomes ill and you have questions or need advice.