Isolated Chronic Osteomyelitis of Fibula in a Child: A Case Report

Authors

1 Department of Pediatric Rheumatology, Bahrami Children’s Hospital, Tehran University of Medical Sciences, Tehran, Iran.

2 Department of Pediatric Infectious Diseases, Bahrami Children’ Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Background
The most common sites affected in pediatric osteomyelitis are long bones of lower extremities such as femur and tibia but isolated fibular osteomyelitis has rarely been reported in children. Here, we present a case of isolated chronic osteomyelitis of fibula in a 2.5-year-old girl. To our knowledge, this is the youngest patient reported with isolated chronic fibular osteomyelitis in literature.
Case Presentation
A 2.5-years-old Iraqi girl was referred to our center with pain and swelling of the right lower leg. Her vital signs were stable and she had partial weight bearing on her right foot. She had been partially treated for acute osteomyelitis 4 months before. She was diagnosed with isolated chronic osteomyelitis of the right fibula and undergone surgical debridement. There was no bacterial growth on blood and bone tissue cultures and the patient was empirically treated with IV cloxacillin and ceftriaxone, followed by oral clindamycin for at least 3 months. At a 6-month follow-up, she was symptom-free and showed complete recovery. 
Conclusion
We present a rare case of isolated chronic fibular osteomyelitis in a child, emphasizing the importance of appropriate empiric antibiotic therapy compatible with the patient’s age and suspected organism in case of negative cultures.

Keywords