Clinical and diagnostic features of osteomyelitis occurring in the first three months of life

摘要: We report a retrospective study of 94 infants, ages <4 months, who underwent investigation for possible osteomyelitis during 9-year period. Of the 30 babies with proven (radiographic changes or positive bone cultures blood plus compatible clinical picture), 17 were preterm artificially ventilated and 4 full term infants receiving intensive care. An etiologic organism was isolated from 28 : methicillin-susceptible Staphylococcus aureus, 16 ; methicillin-resistant S. aureus (MRSA), 7 Escherichia coli, 3 group B Streptococcus, 2. MRSA occurred exclusively in group. Osteomyelitis multifocal 40% associated septic arthritis 47%. The long bones frequently affected (80%) whereas flat often sites clinically silent disease. Twenty-five (83.3%) had focal signs evidence disseminated staphylococcal Only 10 febrile. Four 27 investigated because but no osteomyelitis, as did only 1 suspected sepsis signs. sensitivity 99m Tc scanning 84%, specificity 89%, predictive value 79% negative 92%. addition gallium (in 39 infants) improved respective figures to 90, 97, 93 95% useful interpreting equivocal scans.