Septic osteomyelitis in children is sometimes challenging for physicians to diagnose. The diagnosis often is unclear at the initial evaluation. The initial presentation may be nonspeci c. Children older than 3 months of age with hematogenous osteomyelitis usually present acutely with fever, constitutional symptoms (eg, irritability, decreased appetite or activity). Close monitoring of the clinical course is essential to establishing the diagnosis.
Many common diseases known to us initially have unusual, non-specific clinical manifestations, making diagnosis difficult. We presented cases from our practice where the so-called "Overlap" clinical manifestation occurred. Specifically, a 10-year-old boy with recurrent fever and hemorrhagic rash, with history of epilepsy, and a 5-year-old boy with pleuropneumonia and thrombocytopenia.
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