A Child With Acute Hematogenous Osteomyelitis of the Distal Fibula and Infective Endocarditis

Abstract

Acute hematogenous osteomyelitis (AHO) commonly interests the pediatric population. It typically affects the metaphyses of long tubular bones. However, the fibula is rarely involved. Regarding the hematogenous inoculation, this infection may be associated with distant foci.Herein, we present the case of a 10-year-old girl who was initially diagnosed with atypical AHO of the distal fibula complicated by a subperiosteal abscess. Upon admission, the child showed a severe septic condition, including embolic infective endocarditis (IE), which was responsible for multiple cerebral, renal, and splenic loci. AHO was successfully resolved with appropriate intravenous antimicrobial treatment targeting Staphylococcus aureus, surgical drainage, and debridement. Due to the complexity of the lesions and the embolic nature, the IE was also managed operatively with a mechanical prosthesis.The distal fibula is a rare and challenging location for AHO. EI co-infection should always be sought and suspected because, in such instances, it will genuinely complicate diagnostic and therapeutic management.

Osteomyelitis in a Paediatric Patient with Sub-periosteal Abscess, Septic Pulmonary Emboli and Pneumothorax: A Case Report

“…Trauma is also considered a predisposing factor, as it can lead to bleeding in the metaphyseal capillary network, facilitating bacterial colonization and bone infection. 1 Bacterial osteomyelitis commonly manifests as monofocal bone disease, though multifocal cases are possible. Symptoms include severe inflammation, fever, acute pain, swelling, skin hyperemia, and local hyperthermia.…”