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. 2023 Apr 28;12(4):226-229.
doi: 10.1093/jpids/piad007.

Defining Variability in Evaluation and Management of Children with Chronic Osteomyelitis

Ganga S Moorthy  1 , Angelique E Boutzoukas  1   2 , Daniel K Benjamin  1   2 , Philip M Polgreen  3 , Susan E Beekmann  3 , John S Bradley  4 , Walter Dehority  5
Affiliations

Defining Variability in Evaluation and Management of Children with Chronic Osteomyelitis

Ganga S Moorthy et al. J Pediatric Infect Dis Soc. .

Abstract

Pediatric chronic osteomyelitis is a rare, debilitating condition lacking management guidelines. In a national survey of 162 pediatric infectious disease physicians through the Emerging Infections Network, tremendous variability in diagnostic approaches and management was noted, highlighting a need for a prospective study to better define the spectrum of pathogens and disease.

Keywords: diagnosis; management; pediatric chronic osteomyelitis; prospective studies.

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Figures

Figure 1.
Figure 1.
Factors used to diagnose chronic osteomyelitis in children. Factors used for diagnosis of chronic osteomyelitis in children by 162 pediatric infectious disease physician survey respondents. No respondents stated they were unsure of the necessary diagnostic criteria. Four respondents provided additional criteria, including the use of magnetic resonance imaging (MRI; n = 2) and the exclusion of alternative diagnoses (n = 2). Abbreviations: MRI, magnetic resonance imaging.
Figure 2.
Figure 2.
IV and oral antibiotics. (A) Physician-reported preference for initial use of intravenous (IV) antibiotics in children with chronic osteomyelitis. “Other” free text responses summarized as follows: transition from IV to oral was highly variable or dependent on patient factors (n = 17); emphasized a quick transition from IV to oral antibiotics (n = 7). Missing data for this question for five respondents. (B) Physician-reported criteria for conversion from IV to oral antibiotics in children with chronic osteomyelitis. “Other” free text responses summarized as follows: dependent on patient factors (n = 18); would not use any IV therapy and treat only with oral antibiotics (n = 12). Missing data for this question for two respondents. Abbreviations: IV, intravenous.
See this image and copyright information in PMC

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