RT Book, Section A1 Arnold, Sandra A2 Shah, Samir S. SR Print(0) ID 6909843 T1 Chapter 47. Osteomyelitis T2 Pediatric Practice: Infectious Disease YR 2009 FD 2009 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-148924-9 LK accesspediatrics.mhmedical.com/content.aspx?aid=6909843 RD 2024/11/05 AB Osteomyelitis is an inflammatory condition of bones usually caused by bacterial, or more rarely, fungal infection. Acute hematogenous osteomyelitis (AHO) is the most common form of osteomyelitis in children.1 It occurs as a result of hematogenous deposition of bacteria within bone following symptomatic or asymptomatic bacteremia. The time from onset of symptoms to diagnosis is usually rapid, within 14 days, although certain sites of infection (particularly vertebral and calcaneal) may have a more insidious course and present subacutely.2 Chronic osteomyelitis presents with either chronic, persistent, low-grade symptoms or an exacerbation of symptoms after a period of relative disease quiescence.3 The reported duration of symptoms required to establish a diagnosis of chronic osteomyelitis is quite varied, ranging from 6 weeks to 6 months. The distinction between acute and chronic osteomyelitis is important as it helps define the necessary treatment modalities given that a longer duration of symptoms before treatment may allow for the development of necrotic bone and soft tissues. Nonhematogenous osteomyelitis occurs with direct contamination of bone from trauma, surgery, or spread of infection from an adjacent soft tissue infection.4 This may present as acute or chronic infection. The primary focus of this chapter will be AHO as it is the form of disease that will be seen most commonly in primary care.