Osteomyelitis in pediatrics A case report.

Abstract

Introduction: Osteomyelitis in pediatrics is a severe bone infection that requires timely diagnosis and treatment due to the high rates of sequelae and complications. Bacteria can reach the bone by direct inoculation from traumatic wounds, by dissemination from adjacent tissues affected by cellulitis or septic arthritis, or by hematogenous seeding with the involvement of bone marrow, cortex, periosteum, or surrounding soft tissues. In children, acute bone infection is usually of hematogenous origin. S. aureus is the most common causal agent. Osteomyelitis can be acute, subacute, or chronic. The objective is to describe the approach and treatment of osteomyelitis according to the patient's presentation characteristics, highlighting the role of the multidisciplinary team.

Clinical case: 4-year-old preschooler with a history of oblique fracture of the metaphysis of the left femur, with surgical resolution with non-invasive reduction + external tutors + osteosynthesis with a Rush intramedullary nail, readmission to the emergency room 2 months later due to a 7-day clinical picture characterized by edema, redness, erythema, fever, and inability to walk and stand, purulent discharge at the site of admission of the external tutor. Blood culture reported: methicillin-resistant S. aureus (SAMR). Hospital stay: 67 days.

Conclusion: In the present patient, magnetic resonance imaging was considered useful for the detection and localization of the inflammatory process secondary to infection due to its high sensitivity and validity during the follow-up period, avoiding radiation exposure to the patient.