Diagnosis and Management of Osteomyelitis in Children: A Critical Analysis Review

Area of Science:

• Pediatrics
• Infectious Diseases
• Orthopedic Surgery

Background:

• Pediatric osteomyelitis is a bone infection primarily caused by Staphylococcus aureus.
• Emerging pathogens like Kingella kingae and methicillin-resistant S. aureus (MRSA) are increasingly identified.
• Prompt diagnosis and appropriate management are crucial for favorable outcomes in children.

Purpose of the Study:

• To review the current understanding of pediatric osteomyelitis.
• To highlight diagnostic modalities and treatment strategies.
• To discuss indications for surgical intervention.

Main Methods:

• Literature review of pediatric osteomyelitis diagnosis and management.
• Analysis of causative organisms, imaging techniques, and treatment protocols.
• Evaluation of clinical and laboratory parameters guiding therapy.

Main Results:

• Staphylococcus aureus remains the most common pathogen, with rising rates of Kingella kingae and MRSA.
• Magnetic resonance imaging (MRI) offers high sensitivity and specificity for diagnosis.
• Antibiotic therapy is the mainstay for early osteomyelitis without abscesses, typically involving intravenous followed by oral courses.
• Surgical debridement is indicated for drainable abscesses or treatment failure.

Conclusions:

• Early diagnosis via MRI and prompt antibiotic treatment are key for non-abscess osteomyelitis.
• Clinical assessment, fever, and C-reactive protein levels guide treatment duration and surgical decisions.
• Management requires a tailored approach based on pathogen, imaging, and clinical response.