Related Experiment Video

Updated: Aug 10, 2026

Oral Biofilm Sampling for Microbiome Analysis in Healthy Children
10:42

Oral Biofilm Sampling for Microbiome Analysis in Healthy Children

Published on: December 31, 2017

Changing pattern of osteomyelitis in infants and children

R Tröbs1, R Möritz, U Bühligen

  • 1Klinik und Poliklinik für Kinderchirurgie, Theresienstrasse 43, D-04129 Leipzig, Germany.

Pediatric Surgery International
|July 23, 1999
PubMed

Insights

This study on pediatric osteomyelitis (OM) found Staphylococcus aureus as a common cause. Early intervention for suppurative arthritis is crucial to prevent long-term complications in children.

Area of Science:

  • Pediatric Orthopedics
  • Infectious Diseases
  • Rheumatology

Background:

  • Osteomyelitis (OM) is a significant bone infection in children.
  • Understanding its etiology, clinical course, and treatment outcomes is vital for effective management.

Purpose of the Study:

  • To retrospectively analyze pediatric osteomyelitis cases managed between 1966 and 1996.
  • To evaluate the causative pathogens, clinical presentation, and treatment results.
  • To identify risk factors for unfavorable outcomes and explore atypical forms like chronic recurrent multifocal osteomyelitis (CRMO).

Main Methods:

  • Retrospective analysis of 332 children diagnosed with osteomyelitis.
  • Bacterial culture analysis to identify pathogens.
  • Clinical data review for disease course, sequelae, and risk factors.
  • Evaluation of 10 patients with suspected CRMO since 1989.

Main Results:

  • Bacterial cultures were positive in 64% of cases, with Staphylococcus aureus being the most frequent pathogen.
  • Long bones were affected in two-thirds of cases; 27% had associated arthritis.
  • Moderate to severe sequelae were observed in 19% of re-evaluated patients.
  • Early infancy onset, suppurative arthritis, and epiphyseal involvement were risk factors for poor outcomes.
  • Atypical forms, including CRMO (affecting clavicle in 6/10 patients), were observed with elevated ESR but normal inflammatory markers.
  • Histopathology in CRMO showed lymphoplasmacellular infiltration, suggesting a probable nonbacterial origin.

Conclusions:

  • Staphylococcus aureus is a primary pathogen in pediatric osteomyelitis.
  • Prompt surgical drainage of suppurative arthritis is essential to minimize sequelae.
  • Chronic recurrent multifocal osteomyelitis (CRMO) presents with distinct clinical and laboratory findings, likely having a nonbacterial etiology, though histopathology is inconclusive for differentiation.
  • Risk factor identification aids in predicting and managing pediatric osteomyelitis outcomes.

More Related Videos

A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis08:46

A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis

Published on: August 12, 2020

Related Concept Videos

Bone Formation by Intramembranous Ossification01:29

Bone Formation by Intramembranous Ossification

Intramembranous ossification is one of the two processes involved in the development of bones within an embryo. The flat bones of the face, most of the cranial bones, and the clavicles are formed via this process. During intramembranous ossification, the bones develop directly from sheets of undifferentiated mesenchymal connective tissue.
The process begins when mesenchymal cells in the embryonic skeleton gather together and differentiate into osteogenic cells, which then develop into...
Bone Disorders01:29

Bone Disorders

Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Changes in the Appendicular Skeleton with Age01:09

Changes in the Appendicular Skeleton with Age

The upper and lower limb initially develops as a small bulge called a limb bud, which appears on the lateral side of the early embryo. The upper limb bud appears near the end of the fourth week of development, with the lower limb bud appearing shortly after.
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
Bone Formation by Endochondral Ossification01:24

Bone Formation by Endochondral Ossification

Bone formation, or ossification, begins around the sixth to seventh week of embryonic development. Most bones develop from a cartilaginous template through the process of endochondral ossification. Cartilage formation begins when clusters of mesenchymal cells differentiate into chondrocytes. These chondrocytes proliferate rapidly and secrete an extracellular matrix that becomes encased in a membrane called the perichondrium. The resulting cartilage model provides a template that resembles the...
Development of Human Microbiota01:30

Development of Human Microbiota

The human microbiota begins developing at birth and undergoes continual change as we age. Infancy marks a critical period of microbial sensitivity, offering a “window of opportunity” during which beneficial microbes help mature the immune system. By age three, children typically develop a more stable and diverse microbial community. Newborns acquire microbes from their immediate environment; vaginal delivery favors maternal vaginal microbes, while cesarean births favor microbes from the skin...
Development of the Oral Microbiota01:28

Development of the Oral Microbiota

The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...