title: Neonatal osteomyelitis and complex nephro-ureteral duplication.
abstract: OBJECTIVE
  This report presents a case of femoral osteomyelitis secondary to urinary tract infection in a female neonate with bilateral urinary duplication and right ectopic ureterocele.
  
  
  METHODS
  A female neonate with a history of late perinatal sepsis presented to the emergency department and was found to have left distal femoral osteomyelitis. A complex urological malformation was diagnosed (bilateral renal duplication with right ectopic ureterocele associated with nonfunctional superior pole of the ipsilateral kidney). The baby was submitted to prolonged antibiotic therapy and upper pole nephrectomy of the right kidney.
  
  
  RESULTS
  The pathology report confirmed chronic pyelonephritis and dysplasia in the resected specimen. After 1.5 years the patient is asymptomatic and developing normally, with no apparent deformity, but manifests asymptomatic vesicoureteral reflux.
  
  
  CONCLUSIONS
  Urinary tract infections must always be excluded as the primary infection focus in neonates with sepsis. Perinatal osteomyelitis is almost always a complication of neonatal sepsis and is associated with orthopedic sequelae. This is the first report in literature of a case of osteomyelitis complicating complex urinary duplication and urinary tract infection.
authors.affiliation: Departments of Surgery and Pediatrics, Disciplines of Pediatric Surgery, Pediatrics and Orthopedics, Antônio Pedro University Hospital, Federal Fluminense University, Rio de Janeiro, Brazil. lisieux@uol.com.br
authors.forename: Lisieux Eyer
authors.initials: LE
authors.lastname: de Jesus
authors.forename: Alexandre
authors.initials: A
authors.lastname: Fernandes
authors.forename: Selma Maria Azevedo
authors.initials: SM
authors.lastname: Sias
authors.forename: Carlos Murilo Guedes
authors.initials: CM
authors.lastname: de Mello
authors.forename: Alessandra Mendes
authors.initials: AM
authors.lastname: de Carvalho
authors.forename: Nelson Cruz
authors.initials: NC
authors.lastname: Junior
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007668:Kidney / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery; D009392:Nephrectomy; D010019:Osteomyelitis / Q000175:diagnosis* / Q000188:drug therapy; D014513:Ureter / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery; D014518:Ureterocele / Q000150:complications / Q000151:congenital; D014552:Urinary Tract Infections / Q000150:complications
chemical_list: D000900:Anti-Bacterial Agents