Acute Hematogenous Osteomyelitis

Publication Date: August 4, 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

...veillance and Remediation Acute osteom...

Diagnosis

...iagnos...

...aboratory Tests...

...children with suspected AHO, we reco...

...ildren with suspected AHO, we suggest performin...

...suspected AHO, we suggest against using...


...rential Diagnosis Infection of adjacent soft...

...ive Procedures In children with suspected AHO,...

Imagin...

...n children with suspected AHO, we recommend o...

...with suspected AHO requiring further imaging s...


Treatment

...reatme...

Empiric Antimicrobial Th...

...th presumed AHO who are ill-appearing or have r...

...ldren with presumed AHO who are not...

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


...initive Parenteral and Oral...

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

...n with suspected AHO without an identifie...


...children with AHO requiring a surgical procedur...


...nvasive Therapeutic Proce...

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

...a child with AHO who is clinically...


...sponseIn children with suspected or confir...


...ischarge Planni...

...ren with suspected or documented AHO who re...

...ith suspected or documented AHO who resp...


...of AntibioticsIn children with AHO presumed or...


...-of-Therapy Ima...

...mmend against obtaining end-of-therapy...

...against routine end-of-therapy plain radiogra...

...with complicated AHO or with involv...


...sponse or Relapse...

...ren either experiencing primary treatment fai...

Clinicians should reassess the need for surgica...


...m Follow-upIn children with AHO wh...


...1. Antibiotic Choice and Duration o...

...ibiotic Dosages for Pediatric Acut...