Osteomyelitis of the Femur Associated With Hip Fracture in an Infant

Abstract

Introduction: Osteomyelitis is an infection of the bone and bone marrow, which much frequently occurs in long bones. It is considered of low incidence in the pediatric population; however, it has increased in the last twenty years.

Objective: To describe a clinical case of hip dislocation due to osteomyelitis complication in a pediatric patient.

Case report: We report the case of a 34-day-old infant, who had fever mucopurulent secretions in his umbilical scar; initially he was treated with a double antimicrobial regimen. He did not show improvement, so imaging studies and cultures of the secretions were performed, the latter were negative for bacterial development. Edema with complication of dislocation of the pelvic limb and femur, both on the right side, was observed. He was diagnosed with severe septic arthritis of the right hip and knee, and osteomyelitis of the right femur with extensive destruction of multiple bone and joint structures of the right pelvic limb. Open reduction procedures of hip dislocation, surgical cleaning and biopsy of pathological bone tissue were performed.

Conclusions: Recognizing symptoms and characteristics of osteomyelitis is key for correct diagnosis and treatment. Imaging studies are essential to have an overview of the severity and associated clinical manifestations, and to avoid complications. Newborn care, hygiene and cleaning of the periumbilical area are very important to avoid possible infections, and to guarantee correct healing.