Acute haematogenous osteomyelitis is a bacterial infection of bone, which occurs most frequently in children. Outcomes are excellent for the majority of children, but a minority develop complicated osteomyelitis. Predicting which children will develop complicated osteomyelitis remains a challenge, particularly in developed countries where most patients are discharged home after a relatively short period in hospital.
We conducted a 5-year retrospective case note review of all children aged 3 months to 16 years admitted with a diagnosis of acute haematogenous osteomyelitis. We compared standardized clinical and laboratory parameters in those who developed simple and complicated osteomyelitis.
Of the 299 children who met inclusion, 241 (80.6%) had simple and 58 (19.4%) had complicated osteomyelitis. The major predictors of complicated disease were older age, a temperature greater than 38.5°C and a higher C-reactive protein at admission.
A risk prediction model, utilizing information available shortly after hospitalization, allows early identification of children at greatest risk of developing complicated osteomyelitis.
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From the *Department of General Paediatrics, Princess Margaret Hospital for Children, Perth, Australia; †School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia, ‡Telethon Kids Institute, Perth, Australia; §Department of Orthopaedic Surgery, Princess Margaret Hospital for Children, Perth, Australia; ¶Murdoch Childrens Research Institute, Parkville, Australia; ‖Department of Paediatrics, University of Melbourne, Parkville, Australia; **Department of Paediatrics, Monash University, Clayton, Australia; ††PathWest Laboratory Medicine WA, Princess Margaret Hospital for Children, Perth, Australia; and ‡‡Department of Infectious Diseases, Princess Margaret Hospital for Children, Perth, Australia.
Accepted for publication September 30, 2015.
The authors have no funding or conflicts of interest to disclose.
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Address for correspondence: Andrew C. Martin, MD, Department of General Paediatrics, Princess Margaret Hospital for Children, GPO Box D184, Perth, WA 6840, Australia. E-mail: firstname.lastname@example.org.