By ULY CLINIC Staff,
​
Septic Arthritis and Osteomyelitis in Children
Infection of joints and bones. Usually caused by haematoginous spread of bacteria or resulting from an adjacent focus of infection or penetrating injuries. It can be acute or chronic.
Diagnostic Criteria'
-
Unable to move the affected limb or joint or bear weight on the affected leg and is febrile.
-
Swelling, tenderness and warmth over the joint or bone
-
Periostial bone reaction may be seen
​
If chronic Osteomyelitis
​
-
Discharging sinuses may be present
-
X ray of bone shows sequestrum
Investigations:
-
FBP
-
Blood for culture and sensitivity
-
If septic arthritis aspirate fluid for microbiology, cytology and biochemistry
-
CRP and ESR
Note
-
X-rays may not be helpful in early stages of the disease
Treatment
Non Pharmacological Treatment:
​
-
Encourage breastfeeding and ensure adequate fluid and calorie intake
-
Rest the affected limb
​
Pharmacological Treatment:
For children 3 years or younger
​
-
Give Ampicillin IV 50mg/kg 6 hourly for 3 days, once temperature returns to normal, give Amoxycilin PO 40mg/kg PO 12 hourly for 3 weeks for septic arthritis and 5 weeks for osteomyelitis
-
If no response to above give Cefotaxime IV 50mg/kg 8 hourly. Once temperature returns to normal, give oral Cefixime 4mg/kg 12 hourly for 3 weeks for septic arthritis and 5 weeks for osteomyelitis.
-
Give Paracetamol PO 15mg/kg for pain and high fever
For children aged >3yrs
-
Give Cloxacillin 50mg/kg IV 6 hourly OR Chloramphenicol IV 25mg/kg 6 hourly until temperature returns to normal, then give Flucloxacillin PO 25mg/kg 6hourly for 3 weeks for septic arthritis and 5 weeks for osteomyelitis.
-
If no responses to above give Cefotaxime IV 50 mg/kg 8 hourly until temperature returns to normal, then give Cefixime PO 4mg/kg 12 hourly for 3 weeks for septic arthritis and 5 weeks for osteomyelitis.
-
Give Paracetamol PO 15mg/kg for pain and high fever
Last updated on 14.09.2020
​
​
References
​
-
Tanzanian Standard treatment guideline for children 2017 edition page 85