title: [Acute osteomyelitis: epidemiology, clinical manifestations, diagnosis and treatment].
abstract: OBJECTIVE
  The present study focuses on the epidemiology, clinical and laboratory data, and management of osteomyelitis in a pediatric third level hospital.
  
  
  METHODS
  All cases of children under 15 years-old admitted with osteomyelitis between 2000 and 2011 were retrospectively reviewed until July 2006, then prospectively from then until 2011.
  
  
  RESULTS
  A total of 50 patients were identified (52% males) with median age at diagnosis of 2 years. Principal onset manifestations were pain (94%), functional impairment (90%) and fever (72%). The femur (32%), fibula (28%) and calcaneus (22%) were most affected bones. Leucocytosis > 12.000/μl was found in 56%, elevated ESR > 20 mm/h in 26%, and elevated CRP > 20 mg/L in 64%. Blood culture was positive in 20%, with group A streptococcus being the most frequently isolated bacteria (11%). All diagnoses were confirmed by a (99)Tc scintigraphy bone scan. Antibiotic therapy was initially intravenously (mean time of administration: 10 days ± 3 SD), followed by oral medication (mean time of administration: 18 days ± 6 SD). Surgery was necessary in 3 patients. Evolution of all cases was excellent, despite 3 exceptions that resolved over time.
  
  
  CONCLUSIONS
  The current short-term intravenous therapy led to shorter hospitalizations. There were no statistically significant differences between time from clinical onset or in CRP levels at discharge compared to long-term therapies prior to 2006.
authors.affiliation: Servicio de Urgencias Pediátricas, Hospital La Paz, Madrid, España. drbuenobar@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Bueno Barriocanal
authors.forename: M
authors.initials: M
authors.lastname: Ruiz Jiménez
authors.forename: J T
authors.initials: JT
authors.lastname: Ramos Amador
authors.forename: V
authors.initials: V
authors.lastname: Soto Insuga
authors.forename: A
authors.initials: A
authors.lastname: Bueno Sánchez
authors.forename: M L
authors.initials: ML
authors.lastname: Lorente Jareño
mesh_terms: D000208:Acute Disease; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010019:Osteomyelitis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D011446:Prospective Studies; D012189:Retrospective Studies