Patient education: Osteomyelitis in children (The Basics)

What is osteomyelitis? — Osteomyelitis is an infection of the bone. It can cause pain and other symptoms.

A bone can get infected if there are germs, such as bacteria, in the blood or nearby tissues. Infection can also happen if a child gets a serious injury that exposes the bone. Babies and children who have a weak immune system are at higher risk for osteomyelitis. The immune system is the body's infection-fighting system. Certain health conditions can cause it to be weaker than normal.

When osteomyelitis happens in very young babies, the infection can spread easily to other areas around the bone. This is because the outside of the bones are still very thin. In older babies and children, infection is less likely to spread beyond the bone, but it sometimes happens.

What are the symptoms of osteomyelitis in children? — The symptoms depend on the child's age and where the infection is. They can include:

●Fever

●Pain – Babies and young children might not be able to explain their pain, but will sometimes act fussy or irritable. They might also avoid crawling, or not want to use or put weight on the part with the infection. Older children might complain of pain in a specific area.

If the infection is in the leg, pelvis, or spine, it can cause the child to limp or avoid walking. Sitting might also be painful.

●Inflammation – The infected area might be tender, warm, red, or swollen.

Is there a test for osteomyelitis? — If your doctor or nurse thinks that your child has osteomyelitis based on their symptoms, they will order different tests, such as:

●Blood tests – These include tests to check for bacteria or other germs in the blood.

●Imaging tests – Imaging tests allow the doctor to look at pictures of the bone. X-rays are typically done first. In many cases, another imaging test such as an MRI is also done.

●Tests on a bone sample – This is the best way to know for sure if a child has osteomyelitis. During a bone biopsy, a doctor takes a small sample of bone to send to a lab. The bone sample can be taken with a needle or by doing surgery. Samples might also be taken from the area outside the bone or from fluid in the joints.

Often, doctors will start treatment with antibiotics if they suspect osteomyelitis, even if they have not yet confirmed it. This is because it's important to start treating the infection as soon as possible to keep it from spreading or leading to permanent bone damage.

How is osteomyelitis in children treated? — The first treatment is usually antibiotics. The antibiotics used depend on the child's age and what type of bacteria is causing the infection. Antibiotics are given in the hospital, through a thin tube that goes into a vein (called an "IV"). A child usually can switch to antibiotics taken by mouth after their symptoms have improved. The entire treatment usually lasts for at least 3 to 4 weeks.

Some children also need surgery to remove dead and damaged bone and tissue. Sometimes, surgeons also use screws, plates, or other pieces of "hardware" to support the damaged bone.

Most children who are treated quickly recover without long-term problems. But ff your child's symptoms come back, they should see a doctor or nurse.

What problems should I watch for? — If your child has been diagnosed with osteomyelitis, call for advice if:

●Your child's osteomyelitis symptoms come back.

●Your child has signs of infection – These include fever of 100.4°F (38°C) or higher, or chills.

●Your child has problems with their surgical wound, including:

•Swelling, redness, or warmth around the area

•Yellow, green, or bloody discharge

•Bad smell coming from the area

•The wound opening up

Can osteomyelitis be prevented? — To lower your child's chances of getting osteomyelitis:

●Wash their cuts or wounds with soap and water right away.

●Call your child's doctor or nurse if they have sores that will not heal.

More on this topic

Patient education: Osteomyelitis in adults (The Basics)