Neonatal osteomyelitis in Nigerian infants

Twenty-seven Nigerian infants with osteomyelitis during the first 28 days of life are presented to highlight the severity of the clinical manifestations and the radiological features of this infection. The clinical signs include limitation of movement of the extremities involved and localized swelling. Severe constitutional changes such as fever (greater than 39 degrees C) and abdominal distension were common. This contrasts with results from North America and Europe which emphasize the paucity of clinical signs despite involvement of multiple sites. Multiple site involvement was encountered in only eight cases. Staphylococcus aureus, proteus mirabilis and candida albicans were the main pathogens isolated. The long bones were more frequently affected. Aggressive bone destruction was a constant radiological finding peculiar to staphylococcal osteomyelitis while the formation of sequestrum, a rare occurrence in the newborn, was present in six patients. The mortality rate was 7.4% and the morbidity rate was equally low.