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Osteomyelitis


A serious bone infection that occurs primarily in children between ages five and nine, although it can appear in infants and teenagers as well. The infection that causes osteomyelitis often begins in another part of the body and spreads to the bone via the bloodstream. In children, osteomyelitis typically appears in the long bones. If untreated, the infection can damage the bones and joints, interfering with growth and causing permanent disability. If a joint is infected, the condition is called “pyogenic arthritis.” If the bone tissue dies as a result of the lost blood supply, it may lead to a chronic infection that can persist intermittently for years. Osteomyelitis typically affects two out of every 10,000 people. Risk Factors Osteomyelitis is more common in children who have been recently injured, who have diabetes, who have had their spleen removed, who are undergoing hemodialysis, or who abuse drugs. Symptoms Symptoms of bone infection include pain, swelling, and tenderness in an arm or leg (babies refuse to move the affected arm or leg). This may be followed by fever, nausea and vomiting, or swollen lymph glands. If a joint is affected, the child may have a swollen knee, elbow, wrist, or ankle. Diagnosis The doctor will examine the child and take a blood test to check for a high white blood count (indicating an infection). A needle aspiration of the area around the infected bone can help identify possible bacteria (the child may be anesthetized for this test). A bone scan can reveal infected bone and is often more useful than a standard X ray, which may not show bone changes until at least a week after the infection has begun. Treatment High doses of antibiotics are given for up to six weeks until symptoms improve and an X ray shows the bone is healing. If antibiotics fail to treat the infection, the abscess may need to be surgically drained.