Clinical features of neonatal osteomyelitis.

Abstract

The records of 17 infants (1 to 28 days of age) with osteomyelitis who were admitted over a seven-year period were reviewed. There was a predominance of females (ten of 17). Neither shortened gestational age nor low birth weight seemed to be a predisposing factor. Complications of pregnancy occurred in 41% (seven of 17) of the mothers and the deliveries were complicated in 47% (eight of 17). The majority (15 of 17) of the newborns had antecedent illnesses, or were subjected to potentially infective procedures in the perinatal period. Fifty-nine percent (ten of 17) had known exposure to illness in family members or other close contacts. In 14 of 17 infants the illness was not accompanied by systemic signs or symptoms with only focal manifestations of disease. The most frequent local findings were swelling, tenderness and decreased motion. Deep soft-tissue swelling was the most frequently noted early radiographic change. Penicillin-resistant Staphylococcus aureus (the predominant organism) was isolated in seven of 14 patients in which an organism was identified. Seven of the 17 neonates had multiple bone involvement. Joint involvement was present in 12 of 17 neonates and half of these had a significant functional deficit. Deformity was present in 10 patients four months to seven years after onset of disease; six of these had impaired function. There was one death due to aspiration pneumonia.