Acute hematogenous osteomyelitis of pelvis in children

Acute hematogenous osteomyelitis (AHOM) is a bacterial infection of the skeleton. Typically, it involves tubular bones, but in rare cases, it can affect pelvic bones. It can occur after trauma, operation or by hematogenous diffusion. It is often misdiagnosed due to the anatomic complexity of the pelvis. The aim of this case report is to present unspecific clinical signs and difficulties encountered in the diagnosis of pelvic AHOM. We reviewed clinical signs, diagnostic methods and treatment. A case is presented of a 16-year-old boy admitted to our hospital with abdominal pain, limping, pain in the right hip and fever. After excluding acute abdomen and other possible causes of the mentioned symptoms, an accurate diagnosis was made several days later by scintigraphy. It was a rare case of a pelvic AHOM. Staphylococcus epidermidis was isolated in blood cultures. The patient responded well to antibiotic therapy and was discharged from the hospital without any difficulties. On follow up examinations there were no complications or clinical signs of osteomyelitis. In children with hip pain, limping and fever, pelvic AHOM should always be considered on differential diagnosis. The best diagnostic method is bone scintigraphy and magnetic resonance. Our patients outcome was excellent after antibiotic therapy.

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