Osteomyelitis in immunocompromised children might present differently than in immunocompetent children, and if not treated properly, can have fatal consequences. For this study, scientists looked at the causes, clinical profiles, treatment options, and outcomes of immunocompromised children with osteomyelitis. All immunocompromised children and newborns admitted with osteomyelitis at the hospital between January 2000 and January 2017 and referred to the Paediatric Infectious Disease Service were reviewed retrospectively. A total of fourteen patients were identified. Ten boys (71%) were admitted, with a median age of 70.5 months (interquartile range: 12.3–135.0 months). Two strains of Staphylococcus aureus, two Mycobacterium Bovis (BCG) strains, and one each of Mycobacterium tuberculosis, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Burkholderia pseudomallei, and Rhizopus sp. were shown to be causative organisms. One patient with Clostridium tertium and Clostridium difficile was isolated. The treatment included antimicrobials for a period ranging from 6 weeks to a year, as well as surgery in 11 patients (79%). The individuals were treated for their underlying immunodeficiency wherever possible. Only three patients (21%) made a complete recovery. Five patients (36%) had inadequate bone growth, one had recurrent bone discharge, and one had underlying osteosarcoma that required palliative treatment. Although uncommon, atypical infections can induce osteomyelitis in immunocompromised infants and newborns. Antibiotics are given for a lengthy time, and surgery is performed. Immune recovery appears to play a role in bone repair as well.
Reference:bmcpediatr.biomedcentral.com/articles/10.1186/s12887-021-03031-1
