Acute Hematogenous Osteomyelitis

Publication Date: August 5, 2021

Key Points

Key Points

  • Acute hematogenous osteomyelitis (AHO) occurs when bacteria enter and proliferate within the cellular and extracellular matrix of bone, generally accompanied by a host inflammatory response.
  • The incidence of AHO in children ranges from 1.2 to 13 cases per 100,000 children per year
    • Most of the cases involve a single bone, but about 5% involve multiple bones.
  • The presentation of AHO varies from well-localized infection over a single metaphysis with a minimal associated systemic inflammatory response to multifocal infection with septic shock.
    • Fever and pain are the most common manifestations of bone infection.

Surveillance and Remediation

...and Remediation Acute osteomyeliti...

Diagnosis

...agnosis

...oratory Test...

...n with suspected AHO, we recommend performing...

...n children with suspected AHO, we suggest...

...n with suspected AHO, we suggest against usin...


...erential Diagnosis Infection of adjacent s...

...Procedures In children with suspecte...

...maging...

...ith suspected AHO, we recommend obtaini...

...th suspected AHO requiring further ima...


Treatment

...reatmen...

...ntimicrobial Therapy...

...ith presumed AHO who are ill-appear...

...th presumed AHO who are not clinically...

...with suspected AHO, we recommend using empiric ant...


...efinitive Parenteral and Oral Therap...

...children with confirmed AHO, selection of a de...

...suspected AHO without an identified bacteria...


...AHO requiring a surgical procedure, we recommend...


...ive Therapeutic Procedures...

...en with AHO who present with sepsis or...

...hild with AHO who is clinically stab...


...sponseIn children with suspected or confirmed...


...rge Planning...

For children with suspected or documented AH...

...or children with suspected or docume...


...n of AntibioticsIn children with AHO presumed o...


...-of-Therapy Imaging...

...we recommend against obtaining end...

...est against routine end-of-therapy plain radio...

...h complicated AHO or with involvement o...


...nresponse or Relapse

...ther experiencing primary treatment...

...ns should reassess the need for surgical int...


...ng-Term Follow-upIn children with AHO who are dete...


...otic Choice and Duration of Therapy...

...e 2. Antibiotic Dosages for Pediat...