{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T00:11:33Z","timestamp":1706573493530},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"1-2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,23]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Pediatric osteomyelitis is a rare diagnosis associated with devastating consequences when treatment is delayed. We report a case of hematogenous osteomyelitis in a 5-week-old male presenting to the emergency department (ED) with a flaccid right upper extremity. In the ED, the patient was evaluated with comprehensive infectious and trauma workups. Initial CT imaging of the head and X-ray imaging of the extremity were unremarkable. C-reactive protein was elevated at 0.8; all other laboratory markers were within normal range. Over the course of the ED evaluation, the extremity weakness spontaneously resolved; however, the infant developed a fever of 100.5\u2009F. Empiric broad spectrum antibiotics were initiated, and the infant was admitted to the pediatric service. At 48\u2009hours following presentation, cultures resulted positive for Staphylococcus aureus and MRI imaging revealed osteomyelitis of the proximal right humeral metadiaphysis. Given the subtle presentation of early hematogenous osteomyelitis, emergency providers should maintain a high index of suspicion for infection as the underlying cause in infants presenting with a flaccid extremity.<\/jats:p>","DOI":"10.1093\/milmed\/usad348","type":"journal-article","created":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T14:05:31Z","timestamp":1695045931000},"page":"e457-e459","source":"Crossref","is-referenced-by-count":0,"title":["A Case of\u00a0Hematogenous Osteomyelitis in\u00a0a 5-Week-Old Male"],"prefix":"10.1093","volume":"189","author":[{"given":"Montane B","family":"Silverman","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Brooke Army Medical Center , Fort Sam Houston, TX 78234, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reece E","family":"Tuckerman","sequence":"additional","affiliation":[{"name":"F. Edward Hebert School of Medicine, Uniformed Services University , Bethesda, MD 20814, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Fisher","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Brooke Army Medical Center , Fort Sam Houston, TX 78234, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,9,18]]},"reference":[{"issue":"9431","key":"2024012918213992500_R1","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1016\/S0140-6736(04)16727-5","article-title":"Osteomyelitis","volume":"364","author":"Lew","year":"2004","journal-title":"Lancet"},{"issue":"1","key":"2024012918213992500_R2","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1302\/0301-620X.83B1.0830099","article-title":"The changing epidemiology of\u00a0acute and\u00a0subacute haematogenous osteomyelitis in\u00a0children","volume":"83","author":"Blyth","year":"2001","journal-title":"J Bone Joint Surg Br"},{"issue":"2","key":"2024012918213992500_R3","doi-asserted-by":"publisher","first-page":"116","DOI":"10.31486\/toj.18.0138","article-title":"Acute hematogenous osteomyelitis in\u00a0children","volume":"19","author":"Thakolkaran","year":"2019","journal-title":"Ochsner J"},{"issue":"4","key":"2024012918213992500_R4","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1056\/NEJMra1213956","article-title":"Acute osteomyelitis in\u00a0children","volume":"370","author":"Peltola","year":"2014","journal-title":"N Engl J Med"},{"issue":"12","key":"2024012918213992500_R5","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1097\/00006454-199512000-00004","article-title":"Clinical and\u00a0diagnostic features of\u00a0osteomyelitis occurring in\u00a0the first three months of\u00a0life","volume":"14","author":"Wong","year":"1995","journal-title":"Pediatr Infect Dis J"},{"issue":"12","key":"2024012918213992500_R6","doi-asserted-by":"publisher","first-page":"1662","DOI":"10.2106\/00004623-199912000-00002","article-title":"Differentiating between septic arthritis and\u00a0transient synovitis of\u00a0the hip in\u00a0children: an evidence-based clinical prediction algorithm","volume":"81","author":"Kocher","year":"1999","journal-title":"J Bone Joint Surg Am"},{"issue":"8","key":"2024012918213992500_R7","doi-asserted-by":"publisher","first-page":"e603","DOI":"10.1097\/BPO.0000000000002448","article-title":"Age and\u00a0CRP associated with improved tissue pathogen identification in\u00a0children with blood culture negative osteomyelitis: results from the CORTICES multicenter database","volume":"43","author":"Burns","year":"2023","journal-title":"J Pediatr Orthop"},{"issue":"3","key":"2024012918213992500_R8","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1097\/MOP.0b013e3282ffafd2","article-title":"ALARA: is there a cause for\u00a0alarm? Reducing radiation risks from computed tomography scanning in\u00a0children","volume":"20","author":"Shah","year":"2008","journal-title":"Curr Opin Pediatr"},{"issue":"4","key":"2024012918213992500_R9","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1016\/j.idc.2005.07.006","article-title":"Osteomyelitis in\u00a0children","volume":"19","author":"Kaplan","year":"2005","journal-title":"Infect Dis Clin North Am"},{"issue":"5","key":"2024012918213992500_R10","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1302\/0301-620X.94B5.28523","article-title":"Haematogenous acute and\u00a0subacute pediatric osteomyelitis: a systematic review of\u00a0the literature","volume":"94","author":"Dartnell","year":"2012","journal-title":"J Bone Joint Surg Br"},{"issue":"8","key":"2024012918213992500_R11","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1093\/jpids\/piab027","article-title":"Clinical practice guideline by the Pediatric Infectious Diseases Society and\u00a0the Infectious Diseases Society of\u00a0America: 2021 guideline on\u00a0diagnosis and\u00a0management of\u00a0acute hematogenous osteomyelitis in\u00a0pediatrics","volume":"10","author":"Woods","year":"2021","journal-title":"J Pediatric Infect Dis Soc"},{"issue":"3","key":"2024012918213992500_R12","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1007\/s11999-009-0936-1","article-title":"Sensitivity of\u00a0erythrocyte sedimentation rate and\u00a0C-reactive protein in\u00a0childhood bone and\u00a0joint infections","volume":"468","author":"P\u00e4\u00e4kk\u00f6nen","year":"2010","journal-title":"Clin Orthop Relat Res"},{"issue":"2","key":"2024012918213992500_R13","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1055\/s-0029-1214160","article-title":"Radiographic imaging in\u00a0osteomyelitis: the role of\u00a0plain radiography, computed tomography, ultrasonography, magnetic resonance imaging, and\u00a0scintigraphy","volume":"23","author":"Pineda","year":"2009","journal-title":"Semin Plast Surg"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/189\/1-2\/e457\/56448943\/usad348.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/189\/1-2\/e457\/56448943\/usad348.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T18:23:44Z","timestamp":1706552624000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/189\/1-2\/e457\/7276447"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,18]]},"references-count":13,"journal-issue":{"issue":"1-2","published-online":{"date-parts":[[2023,9,18]]},"published-print":{"date-parts":[[2024,1,23]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usad348","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,1,1]]},"published":{"date-parts":[[2023,9,18]]}}}