# Spontaneous Osteomyelitis and Intraosseous Abscess: A Case Report

## TL;DR

A 9-year-old boy with hip and knee pain and fevers was eventually diagnosed with osteomyelitis and an intraosseous abscess after multiple visits.

## Contribution

Highlights the diagnostic challenges of pediatric osteomyelitis with subtle symptoms.

## Key findings

- The patient had multiple visits before being diagnosed with osteomyelitis and intraosseous abscess.
- Treatment included irrigation, debridement, and intravenous antibiotics.
- The case emphasizes the need to consider osteomyelitis in children with unexplained fever or mobility issues.

## Abstract

Acute hematogenous osteomyelitis may have significant morbidity and mortality if undiagnosed. Because it is uncommon in developed countries and has variable presentations, the patient may undergo several healthcare visits prior to diagnosis.

We report the case of a 9-year-old male who presented with hip and knee pain with associated fevers and was found to have osteomyelitis and intraosseous abscess in the diaphysis of the right femur. He had multiple emergency department and outpatient visits before the ultimate diagnosis was made. He was treated with irrigation and debridement in addition to intravenous antibiotics.

Pediatric acute hematogenous osteomyelitis can have subtle presentations, and this case illustrates some of the difficulties in making the diagnosis. This condition should be considered in the workup of a child with undifferentiated fever, pain, or decrease in mobility.