{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:05:41Z","timestamp":1756339541542,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,11,25]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>Vertebral osteomyelitis is a rare diagnosis and often delayed diagnosis in children. This is a case of a child presenting with fever, back pain and raised C reactive protein who was found to have a <jats:italic>Staphylococcus aureus (S.aureus)<\/jats:italic> bacteraemia. Initial imaging with CT, MRI of the spine and abdominal ultrasound failed to demonstrate a vertebral osteomyelitis or identify another source of the bacteraemia. Due to the high clinical suspicion of a spinal source of the infection, second-line investigations were arranged. A bone scan identified an area of increase metabolic activity in the 12th thoracic vertebrae (T12) and subsequently a diagnosis was confirmed with a focused MRI of T12. This serves as an opportunity to discuss the diagnostic difficulty presented by paediatric vertebral osteomyelitis and more generally the need for clinicians to pursue their clinical suspicion in the face of false negative results to make an accurate and timely diagnosis.<\/jats:p>","DOI":"10.1136\/bcr-2020-236037","type":"journal-article","created":{"date-parts":[[2021,1,26]],"date-time":"2021-01-26T12:40:47Z","timestamp":1611664847000},"page":"e236037","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Difficulties in diagnosing vertebral osteomyelitis in a child"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5702-3041","authenticated-orcid":false,"given":"Jonathan","family":"Holzmann","sequence":"first","affiliation":[{"name":"Paediatrics, Queensland Health, Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunday","family":"Pam","sequence":"additional","affiliation":[{"name":"General Paediatrics, Rockhampton Hospital, Rockhampton, Queensland, Australia"},{"name":"Rural Clinical School, University of Queensland Faculty of Medicine and Biomedical Sciences, Rockhampton, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geoffrey","family":"Clark","sequence":"additional","affiliation":[{"name":"Central Queensland Radiology, Rockhampton Hospital, Rockhampton, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,1,26]]},"reference":[{"key":"2025082710072677000_14.1.e236037.1","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.jor.2016.06.005","article-title":"Spinal infections in children: a review","volume":"13","author":"Tyagi","year":"2016","journal-title":"J Orthop"},{"key":"2025082710072677000_14.1.e236037.2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.105.6.1299"},{"key":"2025082710072677000_14.1.e236037.3","first-page":"519","article-title":"Vertebral osteomyelitis and the role of imaging","volume":"88","author":"Hinners","year":"2017","journal-title":"Radiol Technol"},{"key":"2025082710072677000_14.1.e236037.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2008.03.002"},{"key":"2025082710072677000_14.1.e236037.5","doi-asserted-by":"crossref","first-page":"64","DOI":"10.3109\/03009742.2016.1158314","article-title":"Diagnostic delay of pyogenic vertebral osteomyelitis and its associated factors","volume":"46","author":"Jean","year":"2017","journal-title":"Scand J Rheumatol"},{"key":"2025082710072677000_14.1.e236037.6","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-011-1388-2"},{"key":"2025082710072677000_14.1.e236037.7","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ633"},{"key":"2025082710072677000_14.1.e236037.8","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.83B1.10865"},{"key":"2025082710072677000_14.1.e236037.9","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-013-2850-1"},{"key":"2025082710072677000_14.1.e236037.10","doi-asserted-by":"crossref","first-page":"530","DOI":"10.4329\/wjr.v6.i8.530","article-title":"Role of MRI in the diagnosis and treatment of osteomyelitis in pediatric patients","volume":"6","author":"Pugmire","year":"2014","journal-title":"World J Radiol"},{"key":"2025082710072677000_14.1.e236037.11","doi-asserted-by":"crossref","unstructured":"Babouee Flury B , Elzi L , Kolbe M , et al . Is switching to an oral antibiotic regimen safe after 2 weeks of intravenous treatment for primary bacterial vertebral osteomyelitis? 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