An infant not moving her leg

Tal Berkowitz1, Deborah Young1

  • 1Division of Pediatric Emergency Medicine, Department of Pediatrics, Emory University, Atlanta, GA.

Insights

A 4-week-old infant

Area of Science:

  • Pediatric Infectious Diseases
  • Pediatric Orthopedics
  • Medical Imaging in Pediatrics

Background:

  • Neonatal osteomyelitis is a serious condition that can lead to long-term complications if not diagnosed and treated promptly.
  • Early diagnosis is crucial but can be challenging due to non-specific symptoms in infants.

Observation:

  • A 4-week-old infant presented with non-specific symptoms including decreased movement of the left lower extremity and irritability.
  • Initial X-rays were normal, delaying diagnosis.
  • Repeat imaging revealed a subtle lucency, prompting further investigation.

Findings:

  • Magnetic resonance imaging (MRI) confirmed distal tibial osteomyelitis with an ankle effusion.
  • Group B Streptococcus was identified as the causative pathogen from bone cultures.
  • The infant successfully completed 6 weeks of antibiotic therapy.

Implications:

  • This case highlights the importance of considering osteomyelitis in infants with subtle or non-specific symptoms.
  • Advanced imaging like MRI is critical for diagnosing pediatric bone infections when initial radiography is inconclusive.
  • Prompt antibiotic treatment is essential for favorable outcomes in neonatal osteomyelitis.

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