Spontaneous Osteomyelitis and Intraosseous Abscess: A Case Report

Area of Science:

• Pediatric infectious diseases
• Orthopedic surgery
• Diagnostic challenges in medicine

Background:

• Acute hematogenous osteomyelitis is a serious bone infection with potential for significant morbidity and mortality.
• Its rarity in developed countries and variable clinical presentations often lead to diagnostic delays.
• Delayed diagnosis can result in prolonged patient suffering and increased healthcare utilization.

Purpose of the Study:

• To highlight the diagnostic challenges associated with pediatric acute hematogenous osteomyelitis.
• To emphasize the importance of considering this condition in children presenting with non-specific symptoms.
• To share a case illustrating delayed diagnosis and successful management.

Main Methods:

• Case report of a 9-year-old male with undiagnosed osteomyelitis.
• Review of the patient's multiple healthcare visits prior to diagnosis.
• Description of the diagnostic workup and treatment provided.

Main Results:

• The patient presented with hip and knee pain and fevers, ultimately diagnosed with osteomyelitis and an intraosseous abscess in the right femur.
• Diagnosis was delayed despite multiple emergency department and outpatient visits.
• Successful treatment involved surgical irrigation and debridement followed by intravenous antibiotics.

Conclusions:

• Pediatric acute hematogenous osteomyelitis can present subtly, posing diagnostic difficulties.
• This condition must be considered in the differential diagnosis of children with undifferentiated fever, pain, or decreased mobility.
• Prompt diagnosis and treatment are essential to minimize morbidity.