If the baby’s skeleton is attacked by bacteria, it is called skeletal infection or osteomyelitis. It is an unusual disease. The infection usually sits in the long legs, for example in the leg of the arm, the femur or in the lower leg.

As the legs of children grow in length, they occur in special growth zones of cartilage at the ends of the bone. A skeletal infection is usually located near the growth zones, for example near the knee joint. The infection can also sit in the vertebrae.

Skeletal infection in children is caused by bacteria that spread to the skeleton through the blood. The bacteria can also spread through a wound, although it is more uncommon. Most often, the infection is due to staphylococci. But other bacteria, such as streptococci, can also cause an infection.

If the child is treated early, the infection usually heals and the child is completely healthy. In single children, a growth zone in the skeleton can be affected, which can cause growth disorders. The child then needs to go on checks and sometimes get treatment of skeleton infection.

Symptoms of skeleton infection in children

It is common for a child to have a skeletal infection

  • get high fever
  • get hurt in the leg, arm or back
  • becomes swollen, red, and hot at the infected site
  • begin to limp or stop using the arm or leg, without first injuring themselves.

Infants do not always get a high fever. Infants and smaller children may react with not using the leg or arm, which may then appear paralyzed.

When should I seek care?

Seek care directly at a health care center, pediatric ward or emergency room if the child has a fever and at the same time

  • have pain in one leg, arm or back
  • limps or stops using the arm
  • is swollen, red and hot on the arm or leg.

If an infant has any of the above symptoms of skeleton infection in children, care should be sought immediately even if the child does not have a fever.

Treatment of skeleton infection in children

If the child has a skeletal infection, treatment starts at once. The child is given antibiotics directly in the blood and you are allowed to stay in the hospital with the child for the time being. After a few days, the treatment usually helps. The child becomes more alert, the fever drops and it usually hurts less.

If the child does not get better from the antibiotic and continues to suffer, surgery may be necessary to remove where.

The child may stay in the hospital for one or two weeks. Thereafter, treatment continues at home when the child receives antibiotics as tablets or in liquid form for about six weeks.


To be able to diagnose, the doctor takes a blood test, a so-called  CRP test, which shows if the child has an infection in the body. A bacterial culture is made by the blood to find out which bacteria it is.

If the doctor suspects a skeletal infection, a referral is written to a pediatric clinic. There, the child is often allowed to do a  skeletal x-ray. If the skeletal infection is at an early stage, it is not always visible on the X-rays and the doctor may need to supplement with so-called skeletal scintigraphy. It is done with the help of a gamma camera. A particular fluid is injected directly into the bloodstream, which makes the infected parts clearly visible. Sometimes the child may also do an ultrasound examination.

To find out which bacteria it is, a tissue sample, a biopsy, is sometimes taken with a thin needle from the infected area. The child is anesthetized during the examination.

Ehtisham Nadeem

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