Acute Hematogenous Osteomyelitis
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
Surveillance and Remediation Acute osteomyel...
Diagnosis
...Diagnosis...
...Laborato...
...children with suspected AHO, we recomme...
...dren with suspected AHO, we suggest pe...
...suspected AHO, we suggest against usin...
...gnosis Infection of adjacent soft ti...
...e Procedures In children with suspect...
...Imaging...
...ildren with suspected AHO, we recommend ob...
...ldren with suspected AHO requiring furth...
Treatment
...Treatment...
...Empiric A...
...ldren with presumed AHO who are ill-appeari...
...hildren with presumed AHO who are not clinical...
...ith suspected AHO, we recommend us...
...Definitive Parentera...
...h confirmed AHO, selection of a defini...
...with suspected AHO without an identifi...
...ren with AHO requiring a surgical procedure,...
Invasi...
...h AHO who present with sepsis or have a rapidly p...
...hild with AHO who is clinically stable...
...s the ResponseIn children with suspected or...
...Discha...
...ith suspected or documented AHO who res...
For children with suspected or documented A...
...ation of AntibioticsIn children with AHO pr...
...End-of-Therapy Im...
...recommend against obtaining end-of-thera...
...against routine end-of-therapy plain...
...ildren with complicated AHO or with invo...
...Nonresponse...
...ldren either experiencing primary treatment failur...
...should reassess the need for surgical...
...Follow-upIn children with AHO who are det...
...Antibiotic Choice and Duration of Therapy for U...
Table 2. Antibiotic Dosages for Pediatric Acut...