Neonatal osteomyelitis: A case series
DOI:
https://doi.org/10.47338/jns.v12.1231Keywords:
Osteomyelitis, Septic arthritis, Neonate, Sepsis, BonesAbstract
Background: Osteomyelitis in the neonatal age group is a rare entity. Its presentation and progression are quite different from osteomyelitis in adults, adolescents, and even children. Due to vague clinical features and the late appearance of changes on X-rays, the diagnosis often gets missed. Additionally, there is a risk of permanent damage to bones and joints.
Case Presentation: Our experience of 3 such interesting cases showed the diagnostic dilemma involved in neonatal osteomyelitis. All 3 cases presented as cellulitis or subcutaneous abscess initially as x-ray changes appeared late (7-10 days after onset of disease). All the babies needed surgical debridement. The average duration of antibiotics given was 35.5 days. No residual sequelae were reported for up to 2 years.
Conclusion: Neonatal osteomyelitis needs a high index of suspicion especially in late-onset neonatal sepsis or prolonged septicemia. This case series emphasizes the need for a low threshold for suspicion and early treatment to avoid permanent disability.
Downloads
Metrics
References
Asmar BI. Osteomyelitis in the neonate. Infect Dis Clin North Am. 1992; 6:117-32.
Riise OR, Kirkhus E, Handeland KS, Flato B, Reiseter T, Cvancarova M, et al. Childhood osteomyelitis-incidence and differentiation from other acute onset musculoskeletal features in a population-based study. BMC Pediatr. 2008; 8:1.
Fisher RG. Neonatal osteomyelitis. NeoReviews. 2011; 12:e374-80.
Blickman JG, van Die CE, de Rooy JW. Current imaging concepts in pediatric osteomyelitis. Eur Radiol. 2004; 14:L55-64.
Offiah AC. Acute osteomyelitis, septic arthritis and discitis: differences between neonates and older children. Eur J Radiol. 2006; 60:221-32.
Gutierrez K. Bone and joint infections in children. Pediatr Clin North Am. 2005; 52:779-94.
Newman LG, Waller J, Palestro CJ, Schwartz M, Klein MJ, Hermann G, et al. Unsuspected osteomyelitis in diabetic foot ulcers. Diagnosis and monitoring by leukocyte scanning with indium in 111 oxyquinoline. JAMA. 1991; 266:1246-51.
Peltola H, Pääkkönen M. Acute osteomyelitis in children. N Engl J Med. 2014; 370:352-60.
Chou AC, Mahadev A. Acute bacterial osteomyelitis in children. J Orthop Surg (Hong Kong). 2016; 24:250–2.
Zhan C, Zhou B, Du J, Chen L. Clinical analysis of 17 cases of neonatal osteomyelitis: A retrospective study. Medicine. 2019; 98:e14129.
Gao Y, Liu R, Rai S, Liang Q, Liu Y, Xiao X, et al. Is early surgical intervention necessary for acute neonatal humeral epiphyseal osteomyelitis: A retrospective study of 31 patients. Child. 2022; 9:527.
Sukswai P, Kovitvanitcha D, Thumkunanon V, Chotpitayasunondh T, Sangtawesin V, Jeerathanyasakun Y. Acute hematogenous osteomyelitis and septic arthritis in children: clinical characteristics and outcomes study. J Med Assoc Thai. 2011; 94:S209-16.
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Parveen Kumar, Ankur Bhardwaj, Anil Agarwal, Divyamedha Agarwal
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
