# Paediatric Cervical Osteomyelitis With an Atypical Presentation: A Case Report and Literature Review

## TL;DR

A child with cervical osteomyelitis showed unusual symptoms, highlighting the need for timely diagnosis and treatment.

## Contribution

This case report presents an atypical pediatric cervical osteomyelitis case with delayed diagnosis and prolonged treatment.

## Key findings

- The patient's symptoms began with neck spasms and later included fever and lymphadenitis.
- MRI confirmed cervical osteomyelitis at the C3-C4 level despite negative blood cultures.
- Prolonged IV antibiotic treatment over 16 weeks led to full recovery without complications.

## Abstract

Cervical osteomyelitis is an uncommon condition in children. Diagnosis can prove difficult due to non-specific symptoms. We describe a case of paediatric cervical osteomyelitis that initially manifested with neck spasms, later progressing to fever and lymphadenitis, illustrating the variable clinical course of the condition. Investigations showed elevated inflammatory markers. The initial blood culture was reported as a contaminant, with subsequent blood cultures remaining negative. Magnetic resonance imaging (MRI) confirmed the diagnosis of cervical osteomyelitis at the C3-C4 level. The patient required prolonged intravenous (IV) antibiotics for 16 weeks due to persistent symptoms and MRI findings. Management was guided by a Multidisciplinary Team (MDT). The patient made a full recovery without any residual complications.

This case highlights the importance of timely diagnosis and appropriate management for a favourable prognosis in children with cervical osteomyelitis.