Health Library

Osteomyelitis is a bone infection that is caused when bacteria or other germs get inside a bone. This can happen if your child has an infection in another part of their body and the infection spreads through the blood to their bone.

It can also happen if your child has a wound or a broken bone, also called a fracture, that breaks their skin and lets germs in that spread to the bone.

Bone infections need to be treated quickly to prevent damage to the child's developing bones.

What are the causes?

1. Bacteria. Most bone infections are caused by a type of bacteria called staphylococcus that is found on the skin.
2. Other germs, such as a virus or a fungus.

What increases the risk?

a. This condition is more likely to develop in children who:

1. Recently had surgery, especially bone or joint surgery.

b. Have certain diseases, such as:

1. Diabetes.
2. Rheumatoid arthritis.
3. Kidney disease with dialysis.

c. Are 5 years old or younger, because:

1. Young children do not have a completely developed body defense system, also called the immune system. This makes it harder for them to fight infections.
2. They are likely to fall and cut or scrape their skin.

d. Have a condition or take medicines that block or weaken the body's defense system.

e. Have had a joint or bone fixed with plates or screws.

f. Have had an injury, such as stepping on a nail or having a fracture that exposes bones through the skin.

What are the signs or symptoms?

In children, the bones of the arms and legs are most often affected. Symptoms depend on the type and place of the child's infection. Symptoms may include:

1. Fever and chills.
2. Redness and warmth near the infection.
3. Swelling.
4. Pain and stiffness.
5. Fluid or pus draining near the infection.
6. A limp arm or leg.
7. Refusing to walk or use an arm.
8. Getting annoyed easily.
9. Not feeling hungry.
10. Throwing up.

How is this diagnosed?

This condition may be diagnosed based on:

1. Your child's symptoms and medical history.
2. A physical exam.

Tests such as:

1. A small amount of tissue, fluid, or blood taken for testing.
2. Pus or discharge swabbed from a wound for testing. This is to find out the type of germs that are causing the infection and what type of medicine will kill them.
3. Blood tests.
4. Imaging tests, such as X-rays, MRI, CT scan, bone scan, or ultrasound.

How is this treated?

Treatment depends on the cause and type of infection. Antibiotics are usually the first treatment. Your child may need to continue IV antibiotics at home or take antibiotics by mouth for several weeks after that.

Other treatments may include surgery:

1. To remove dead or dying tissue from a bone or joint.
2. To take out infected plates or screws that were used to fix a broken bone.

Follow these instructions at home:

Medicines

1. Give your child medicines only as told.
2. Give your child antibiotics as told. Do not stop giving the antibiotics even if your child starts to feel better.
3. Follow instructions from your child's health care provider about how to give IV antibiotics at home. You may need to have a provider come to your home to give your child IV antibiotics.

General instructions

1. Have your child rest as told.
2. Ask what things are safe for your child to do at home. Ask when your child can go back to school.
3. Keep all follow-up visits. Your child's provider will need to check on their condition.

How is this prevented?

1. Have your child wash their hands often to stop the spread of germs. They should wash their hands for at least 20 seconds with soap and water. If they can't use soap and water, they should use hand sanitizer.
2. Keep any open areas, cuts, or wounds clean. Put on a clean bandage after cleaning the area.
3. Check your child's wounds often for signs of infections. Signs of infection include redness, swelling, warmth, pus, or a bad smell.
4. Have your child wear shoes to prevent injuries to their feet.

Contact a health care provider if:

Your child has redness, warmth, pain, or swelling that comes back after treatment.

Your child's symptoms get worse, or your child has any of these symptoms:

1. A fever or chills.
2. A limp.
3. Refusing to walk.
4. Not using an arm or a leg.
5. Refusing to eat.
6. Seems to have no energy.
7. Being very upset or annoyed easily.

Get help right away if:

1. Your child has fast breathing or has trouble breathing.
2. Your child can't drink anything or can't pee.
3. The affected arm or leg swells, changes color, or turns blue.

These symptoms may be an emergency. Do not wait to see if the symptoms will go away.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.