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DOI: 10.1055/s-0035-1570320
A Rare Full-Term Newborn Case of Rib Osteomyelitis with Suspected Preceding Fracture
Publikationsverlauf
29. Oktober 2015
04. November 2015
Publikationsdatum:
18. Februar 2016 (online)
![](https://www.thieme-connect.de/media/ajpr/201601/lookinside/thumbnails/10-1055-s-0035-1570320_150076-1.jpg)
Abstract
Acute osteomyelitis is uncommon in full-term neonates and occurs most frequently in those with critical illnesses, often following episodes of sepsis, skin infection, umbilical catheterization, urinary tract anomalies, or a complicated delivery. Here, we report a very rare case of acute rib osteomyelitis due to Staphylococcus aureus in a 13-day-old full-term male neonate. Ultrasonography (US) enabled diagnosis and revealed a coexisting costochondral junction rib fracture, which was not detected on routine chest radiography. Following a 29-day course of intensive parenteral antibiotic therapy, the patient was discharged in good health at 42 days of age without any scar formation. Due to its accessibility and safety, US can be a promising modality for detecting acute osteomyelitis in neonates with clinically highly suspected conditions in the neonatal intensive care unit setting, particularly those involving thin and mobile bones subject to respiratory motion. However, further studies are required to assess the utility of US in these cases and negative results. In low-risk neonates with osteomyelitis, an accompanying fracture should be considered.
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References
- 1 Knudsen CJM, Hoffman EB. Neonatal osteomyelitis. J Bone Joint Surg Br 1990; 72 (5) 846-851
- 2 Wong M, Isaacs D, Howman-Giles R, Uren R. Clinical and diagnostic features of osteomyelitis occurring in the first three months of life. Pediatr Infect Dis J 1995; 14 (12) 1047-1053
- 3 de Jesus LE, Fernandes A, Sias SM, de Mello CM, de Carvalho AM, Junior NC. Neonatal osteomyelitis and complex nephro-ureteral duplication. Surg Infect (Larchmt) 2011; 12 (1) 73-75
- 4 Overturf GD. Bacterial infections of the bones and joints. In: Remington JS, Klein JO, Wilson CB, Nizet V, Maldonado Y, eds. Infectious Diseases of the Fetus and Newborn. 7th ed. Philadelphia: WB Saunders; 2010: 296-310
- 5 Herman TE, Siegel MJ. Osteopenia of prematurity, staphylococcal rib osteomyelitis. J Perinatol 2009; 29 (3) 254-255
- 6 Nascimento M, Oliveira E, Soares S, Almeida R, Espada F. Rib osteomyelitis in a pediatric patient case report and literature review. Pediatr Infect Dis J 2012; 31 (11) 1190-1194
- 7 Basa NR, Si M, Ndiforchu F. Staphylococcal rib osteomyelitis in a pediatric patient. J Pediatr Surg 2004; 39 (10) 1576-1577
- 8 Cesarini C, Macieira S, Girard C, Drolet R, d'Anjou MA, Jean D. Costochondral junction osteomyelitis in 3 septic foals. Can Vet J 2011; 52 (7) 772-777
- 9 van Rijn RR, Bilo RA, Robben SG. Birth-related mid-posterior rib fractures in neonates: a report of three cases (and a possible fourth case) and a review of the literature. Pediatr Radiol 2009; 39 (1) 30-34
- 10 Griffith JF, Rainer TH, Ching AS, Law KL, Cocks RA, Metreweli C. Sonography compared with radiography in revealing acute rib fracture. AJR Am J Roentgenol 1999; 173 (6) 1603-1609
- 11 Kelloff J, Hulett R, Spivey M. Acute rib fracture diagnosis in an infant by US: a matter of child protection. Pediatr Radiol 2009; 39 (1) 70-72
- 12 Riebel TW, Nasir R, Nazarenko O. The value of sonography in the detection of osteomyelitis. Pediatr Radiol 1996; 26 (4) 291-297
- 13 Offiah AC. Acute osteomyelitis, septic arthritis and discitis: differences between neonates and older children. Eur J Radiol 2006; 60 (2) 221-232
- 14 Krogstad P, Hematogenous osteomyelitis in children: clinical features and complications. In: Torchia MM. , ed. UpToDate. 2015. Retrieved from http://www.uptodate.com/home/index.html . Accessed April 2, 2015