[Neonatal group B streptococcal osteomyelitis: report of a case]

A 31-day-old female infant was admitted through the Emergency Room, on account of a nodular mass over the left middle clavicle region for 2 weeks and swelling of right groin for one day. The physical examination showed a nodular mass (3 cm in diameter) on the left middle clavicle region, with swelling and tenderness on the right groin. Needle aspiration of the nodular mass on the left middle clavicle region yielded Group B beta--hemolytic streptococcus (GBS). X-ray showed fracture of the left clavicle bone with callus formation, and swelling of soft tissue of the right thigh. Tc99m bone scan showed hyperemic change at the middle of left clavicle bone and the right hip joint. Arthrotomy was done to drain a large amount of pus containing GBS. After five weeks of antibiotics treatment, the patients condition was stable. Neonatal GBS osteomyelitis almost always involves single bone. Reports of two bones involvement are few. The patient's clavicle and femur involvement was an unusual presentation.