Acute multifocal haematogenous osteomyelitis in children

Area of Science:

• Pediatric Infectious Diseases
• Orthopedic Surgery
• Microbiology

Background:

• Haematogenous multifocal osteomyelitis in children is a severe condition with a high risk of rapid sepsis development.
• Early and effective treatment is crucial for favorable outcomes.

Purpose of the Study:

• To analyze the clinical presentation, causative organisms, laboratory findings, and risk factors of acute multifocal haematogenous osteomyelitis in children.
• To assess treatment outcomes and identify potential trends in microbial resistance.

Main Methods:

• Retrospective analysis of 26 pediatric patients diagnosed with acute multifocal osteomyelitis over five years.
• Inclusion criteria: patients over 1 year old with involvement of two or more bones, presenting within one week of symptom onset.
• Evaluation included clinical examination, blood tests, and local ultrasound.

Main Results:

• The average age of presentation was 4.9 years, with a female predominance (1.4:1 ratio).
• Lower limbs were most commonly affected (92%), particularly the tibia (73.1%).
• Staphylococcus aureus was the predominant pathogen, with 50% of isolates being methicillin-resistant S. aureus (MRSA). Blood cultures were positive in 38.5% of cases.

Conclusions:

• Early diagnosis and timely, adequate treatment are essential for managing acute multifocal haematogenous osteomyelitis in children.
• The high prevalence of MRSA indicates a shift in causative agents for multifocal bone infections in this population.