Neonatal osteomyelitis: regarding a case

Abstract

Introduction: acute bacterial osteomyelitis is a serious and infrequent disease that affects neonates and infants and can cause permanent osteoarticular sequelae; at these stages of life the disease has different etiopathogenic and histological features to those that characterize it in patients of other ages, and therefore it is considered an entity of its own.

Objective: to present a case of neonatal osteomyelitis that, as an entity not reported in the medical literature, is of interest to health personnel.

Case report: a 27-day old male patient who presented loss of appetite, irritability, and fever that gave way with the use of antipyretics; on physical examination, an increase in the volume of the left elbow joint was observed, with pain of moderate intensity and difficulty in making movements; complementary examinations were done and the affected limb was immobilized with a posterior ferule for the elbow. An aspiration puncture of the proximal metaphyseal zone of the elbow was carried out; the diagnosis was acute hematogenous osteomyelitis of the proximal third of the radius, without being able to verify the primary infectious focus. The patient was treated with antimicrobials during fourteen days; treatment was continued for three months.

Conclusions: in the presence of joint pain, inflammation of the limbs and stigmas characteristic of osteomioarticular system infection in newborns and infants, the specialist should take into account the possibility of acute bacterial osteomyelitis; delays, both in diagnosis and in treatment, have a poor prognosis for the patient.