Childhood Osteomyelitis: What You Should Know

Osteomyelitis is a bone infection that can affect both children and adults, but it is more common in young children due to their active lifestyles and developing immune systems. It can cause severe pain and discomfort and, if left untreated, may lead to long-term complications. In this blog, we’ll take a closer look at osteomyelitis in children, exploring what it is, its causes, symptoms, and available treatments.

What is Osteomyelitis?

Osteomyelitis is an infection of the bone, typically caused by bacteria, although other pathogens like fungi or viruses can also be responsible. In children, it most commonly affects the long bones of the legs and arms, though it can occur in any bone. The infection can develop in two ways:

1. Hematogenous Spread: This is the most common way osteomyelitis occurs in children, where bacteria enter the bloodstream and travel to the bone, causing an infection.

2. Contiguous Spread: This occurs when an infection from surrounding tissue (such as a skin wound or joint infection) spreads into the bone.

Early diagnosis and prompt treatment are essential for preventing complications such as bone damage or the spread of infection to other parts of the body.

Causes of Osteomyelitis in Children

In most cases, osteomyelitis in children is caused by bacteria, with Staphylococcus aureus (including methicillin-resistant Staphylococcus aureus, or MRSA) being the most common culprit. Other bacteria that can cause osteomyelitis include Streptococcus and Escherichia coli.

The infection often begins when bacteria enter the body through a break in the skin, such as a cut, scrape, or surgical wound. Children who have undergone recent surgery, especially bone surgery, are at higher risk. In addition, children with weakened immune systems, those with chronic conditions such as diabetes or sickle cell disease, or those who have had intravenous lines or catheters may also be more susceptible to osteomyelitis.

Symptoms of Osteomyelitis in Children

The symptoms of osteomyelitis can vary depending on the age of the child and the severity of the infection. Common symptoms include:

• Pain: The infected bone becomes painful, and the child may have difficulty moving the affected limb or using it for normal activities.

• Swelling and Redness: The skin over the infected bone may appear red, swollen, or warm to the touch.

• Fever: Osteomyelitis often causes a fever, indicating the body’s response to infection.

• Irritability and Loss of Appetite: Young children, especially babies, may show signs of irritability, fussiness, and a decrease in appetite.

• Limping: In children, osteomyelitis in the legs or feet can cause limping or an inability to walk normally.

• General Malaise: The child may appear tired or lethargic and may show signs of generalized discomfort.

If a child experiences these symptoms, it’s crucial to seek medical attention promptly to avoid complications.

Diagnosing Osteomyelitis

Diagnosing osteomyelitis typically involves a combination of physical examination, medical history review, and diagnostic tests. The doctor may recommend:

• Blood Tests: Blood tests can show signs of infection, such as elevated white blood cell count or increased C-reactive protein (CRP) levels.

• X-rays: While X-rays may not show early-stage osteomyelitis, they can help detect bone damage caused by the infection.

• MRI or CT Scan: These imaging techniques are more effective at detecting bone infection, particularly in the early stages.

• Bone Biopsy or Aspiration: In some cases, a small sample of bone or fluid may be taken from the affected area to identify the bacteria causing the infection and determine the best treatment.

Treatment of Osteomyelitis in Children

Osteomyelitis requires prompt treatment to prevent serious complications. The treatment approach typically involves a combination of antibiotics and, in some cases, surgery:

1. Antibiotics: The main treatment for osteomyelitis is antibiotics. Initially, the child may receive intravenous (IV) antibiotics in the hospital. Once the infection is under control, oral antibiotics may be prescribed for several weeks to fully treat the infection. The specific antibiotic used depends on the bacteria identified during testing.

2. Surgery: In severe cases, surgery may be required to remove infected tissue or drain abscesses that form around the bone. This can help reduce pressure on the bone and prevent further spread of the infection.

3. Pain Management: Pain relief is an important part of treatment. Doctors may recommend pain medications to help manage the discomfort associated with osteomyelitis.

4. Physical Therapy: After the infection is treated, physical therapy may be recommended to help the child regain strength and mobility, especially if the infection caused significant bone damage.

Prognosis and Recovery

With early diagnosis and treatment, most children recover fully from osteomyelitis and do not experience long-term complications. However, if left untreated, osteomyelitis can lead to serious complications such as bone deformities, chronic infections, or septic arthritis (infection in the joints).

Children who experience recurrent infections or severe bone damage may need long-term care, including additional surgeries or physical therapy. Regular follow-up appointments are essential to ensure the infection is fully resolved and to monitor the child’s recovery.

Preventing Osteomyelitis in Children

While osteomyelitis cannot always be prevented, there are several steps that can reduce the risk:

• Proper Wound Care: Clean and cover cuts, scrapes, and surgical wounds properly to prevent bacteria from entering the body.

• Good Hygiene: Encourage regular hand washing and good hygiene practices to reduce the risk of infection.

• Prompt Medical Attention: If a child has a fever or appears to be in significant pain, seek medical attention early to prevent potential infections from spreading.

Conclusion

Osteomyelitis in children is a serious condition that requires prompt medical attention to prevent long-term damage. With early diagnosis and appropriate treatment, most children can recover fully and regain normal function. If you suspect your child may have osteomyelitis, it is essential to seek medical advice from a paediatric orthopaedic specialist who can provide the necessary care and guidance. At Children Ortho Care, we are committed to helping children recover from bone infections and live healthy, active lives.