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Pediatr Infect Dis J. 2003 Aug;22(8):731-6.

Culture-negative osteomyelitis.

Author information

1
Division of Infectious Diseases, Department of Pediatrics, LSU Health Sciences Center, Louisiana State University, New Orleans, LA, USA.

Abstract

OBJECTIVE:

To examine the natural history, clinical manifestations, laboratory changes and outcomes of children with culture-negative osteomyelitis and to compare findings with cases of culture-positive infection treated during the same time period.

DESIGN:

Retrospective review of consecutive admissions for osteomyelitis during the 4-year period 1998 through 2001, with a minimum follow-up of 1 year.

SETTING:

A single urban children's hospital with a large orthopedic referral service. CLINICAL AND LABORATORY MEASURES: Age, gender, predisposing factors, clinical manifestations, maximum temperature, duration of pain, bone involved, laboratory changes, results of cultures from infected bone and blood and outcome after treatment.

RESULTS:

A total of 85 patients fulfilled study criteria, of whom 40 were culture-negative. Compared with culture-positive cases, culture-negative osteomyelitis patients were less likely to have antecedent trauma (P = 0.0357) and overlying skin changes (P = 0.0001), duration of pain and other symptoms was longer (P = 0.0396) and skeletal residua were rare. They were also older, with this difference approaching statistical significance (P = 0.0586).

CONCLUSIONS:

Children with culture-negative osteomyelitis present initially differently from culture-positive cases and can be managed as presumed staphylococcal disease with excellent long term results.

[Indexed for MEDLINE]

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