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Acute haematogenous osteomyelitis in children

Acute haematogenous osteomyelitis remains a significant cause of morbidity in the paediatric population. The clinical presentation has changed, however, over the last number of decades. The typical picture of established osteomyelitis is less commonly seen. Children more often present with a less fulminant picture. The treatment of acute haematogenous osteomyelitis remains controversial. Antibiotic therapy, initially intravenous, then orally, is the gold standard. Hover, the role of surgery is unclear. Some centres, particularly in North America treat 25–40% of patients surgically. We present our experience with acute haematogenous osteomyelitis in children over a three year period. The total number of patients was forty-five. The mean age was 6.1 (range 6 months to thirteen years). The most common isolated organism was Staphylococcus Aureus. The mode of treatment was intravenous antibiotics for two weeks, or until clinical, and laboratory evidence of improvement, and the oral antibiotics for six weeks. No patients required surgical interventioin. All patients made a satisfactory recovery. We conclude that the treatment of acute haematogenous osteomyelitis in the paediatric population should consist of antibiotic therapy only, and that there is no place for surgery.