Osteomyelitis in children

What is osteomyelitis in children?

Osteomyelitis (os·​te·​o·​my·​e·​li·​tis) is an infection of a bone by a germ (bacteria). In children, infections most commonly occur in the long bones of the arms and legs. A child with osteomyelitis will be referred to an orthopedist (doctor specializing in treating bone and joint problems) or infectious disease specialist for evaluation and treatment.

How is osteomyelitis in children treated?

Antibiotic treatment

Prescribing antibiotics is the mainstay of treatment for infections.

• Intravenous - At first, your child will need to stay at the hospital to receive antibiotics through the veins (intravenous or IV). How long your child will stay in the hospital will depend on how severe the infection is. Most children with bone, joint, or muscle infections are in the hospital for 4-7 days.

• PICC line - Some children can continue to receive an antibiotic by vein at home through a special intravenous device called a PICC (pronounced "pick") line. This is a peripherally introduced central catheter (PICC).

• Oral - For many children the antibiotic is eventually changed to a form which can be taken by mouth (oral) and given at home.

The amount of time on antibiotics needed to resolve an infection varies from child to child, but in general is 4 to 6 weeks for a bone infection and 3 to 4 weeks for joint or muscle infections.

Surgical treatment

In mild infections, antibiotics alone may resolve the condition. Some children, however, will need surgery to remove infected material (pus) from the area of infection. This will reduce pressure and inflammation, and improve blood flow, which will make it easier for the antibiotics to reach the infected area.

For most children, one surgical procedure is enough, but severe infections may require two or more surgeries to help resolve the infection.

• Recovery - Most children will completely recover from bone infections after proper treatment. They are not likely to develop the same infection again. In most cases, children have no further problems and return to all of their activities.

• Prognosis - In general, children do better when the infection is recognized early. There is a greater chance for full recovery when the infection is quickly recognized and treated. The later the diagnosis is made, the more likely it is that the infection will cause greater damage to the bones, muscles and other tissues that are involved.

Some problems can occur in children who have serious and prolonged infections. These include blood clots, growth arrests, deformed bones, fractures through bone that is weakened from infection, bone death (called necrosis), and joint stiffness. However, these problems are rare.