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Osteomyelitis in Children

What is acute osteomyelitis?

Acute osteomyelitis is an infection in the bone. It develops over a short time, usually about 2 weeks. In children, osteomyelitis is more common in the long bones of the arms and legs. But it can affect any bone in the body. Osteomyelitis can happen in children of any age. About half of the time, it occurs in children under 5 years of age.

What causes acute osteomyelitis?

Osteomyelitis occurs when a bacterial infection from another part of the body spreads to the bone. In children, an infection in the blood is a common cause of osteomyelitis. This is because a child's growing, bones have an increased blood supply. That makes it easier for the bacteria to get into the bone. An infection from nearby soft tissue or from a wound may also lead to osteomyelitis.

In children, the bacteria that most often cause osteomyelitis is Staphylococcus aureus or Staph.

What are the symptoms of osteomyelitis?

These are common symptoms of osteomyelitis:

  • Fever
  • Fussiness or irritability
  • Tiredness
  • The following may occur in the area of the infected bone:
    • Tenderness or pain
    • Not using the affected arm, leg or other part of the body
    • Swelling
    • Redness

Seek medical attention right away if you think your child has osteomyelitis. The symptoms of osteomyelitis may look like other conditions or health problems. Always consult your child's doctor for a diagnosis.

How is osteomyelitis diagnosed?

The sudden development of symptoms and the physical exam are key to diagnosing osteomyelitis.

Your child may have the following tests:

  • Blood culture. A blood sample is checked for bacteria.
  • Blood tests. Some abnormal results mean there is an infection in the body.
  • Bone biopsy. A sample of bone is taken and checked for bacteria.
  • Imaging tests. X-rays, a bone scan, and an MRI may be done.

How is osteomyelitis treated?

Your child’s healthcare provider will figure out the best treatment based on:

  • How old your child is
  • His or her overall health and medical history
  • How sick he or she is
  • How well your child can handle specific medicines, procedures, or therapies
  • How long the condition is expected to last
  • Your opinion or preference

Your child will probably be treated by one or more specialists. He or she will be given antibiotics. First into a vein (intravenous, or IV) for at least 3 days. And, then by mouth for a few weeks. Other treatment will be given to ease pain. Surgery to remove infected tissue may be done. But this is uncommon in children.

What are the complications of osteomyelitis?

Most of the time, antibiotic therapy gets rid of the infection. Although not common in children, the infection can become long-term or chronic.

When should I call my child's healthcare provider?

Call the healthcare provider if your child has any of the following:

  • Fever
  • Fussiness or irritability
  • Tiredness

Also call the provider if your child has any of these In the area of the infection:

  • Tenderness or pain
  • Not using that part of the body
  • Swelling
  • Redness

Key points about osteomyelitis

  • Osteomyelitis is an infection in the bone.
  • In children, it is more common in the long bones.
  • In children, it is often from a blood infection.
  • Antibiotics are used to treat osteomyelitis.


Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:
  • Before your visit, write down questions you want answered.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you for your child.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

Medical Reviewers:

  • Freeborn, Donna, PhD, CNM, FNP
  • Holloway, Beth, RN, M.Ed.