Challenges in Diagnosis of ChronicOsteomyelitis : ACase Report from Sri Lanka

V Thadchanamoorthy,Kavinda Dayasiri

doi:10.31344/ijhhs.v5i1.246

Abstract

The prevalence of osteomyelitis has been continuously decreasing in children with improvement of health care services and introduction of Hemophilus and Pneumococcal vaccines. Despite this, diagnosis and management of osteomyelitis are often a challenge to pediatricians as well as orthopedic surgeons. We report a 13-year old boy who had been treated as for rheumatic fever over 2 years with Benzathene penicillin, but ultimately turned out to have chronic osteomyelitis of right tibia. Evidence of chronic osteomyelitis was radiologically confirmed by X-ray and Computerized tomogram (CT) of right tibia and pus cultures grew staphylococcus aureus. Clinical features and biochemical markers completely resolved upon debridement of pus and intravenous antibiotics. He is currently on follow up at the orthopedic and pediatric clinics in the local hospital.International Journal of Human and Health Sciences Vol. 05 No. 01 January’21 Page: 118-121

Highlights

Chronic osteomyelitis frequently affects long bones of arms and legs in children, but other bones are not exempt[1]
In whom chronic osteomyelitis was initially mistakenly diagnosed as rheumatic fever and chorea, and 4-weekly prophylaxis with Benzathene penicillin was given for one year, before the diagnosis of chronic osteomyelitis was confirmed in retrospect
He had been investigated for right knee joint pain, and fever with blood and radiological investigations at the local hospital.The investigations revealedelevated C-reacting protein (CRP), increased erythrocyte sedimentation rate (ESR), antistreptolysin O titre (ASOT) >800 U/ mLand increased white blood cells

Summary

Introduction

Chronic osteomyelitis frequently affects long bones of arms and legs in children, but other bones are not exempt[1]. The organisms spread to bone either from blood or adjacent tissues[4].Diagnosis is naturally based on clinical features and supported by microbiological and radiological confirmation[5]. Chronic osteomyelitis is a rare disease in children[7], it might cause severe sequelae such as growth failure, septic arthritis, destruction of joints, and permanent disability[8].

Results

Conclusion