A case of emphysematous osteomyelitis in the pediatric practice

Introduction. Emphysematous osteomyelitis is a life-threatening and rare disease in the clinical practice. A distinctive feature of the disease is gas in bones and in surrounding soft tissues on the background of predisposing factors which significantly worsen patient’s general condition (malignant neoplasms, diabetes mellitus, immunodeficiency, injuries and fractures). The authors present a clinical observation of diagnostics and management of emphysematous osteomyelitis in the right femur head in a 12-year-old child. The disease developed two months after a closed right-sided fracture of the femoral trochanter. In the literature, one can meet not more than 50 cases of emphysematous osteomyelitis.

Relevance. In the available medical literature, we have not found any description of emphysematous osteomyelitis in children, so we considered it appropriate to publish a rare clinical case.

Purpose. To analyze a rare case of emphysematous osteomyelitis in a child and to identify possible diagnostic and therapeutic errors occurred in the discussed case in Children’s Republic Clinical Hospital in Saransk.

Conclusion. Currently, hematogenous osteomyelitis in children has become less common, and therefore there is no alertness for this pathology in physicians. We also have faced emphysematous osteomyelitis in our practice for the first time. Therefore, only when child’s condition worsened on day 4 after hospitalization, additional diagnostic tools were added, namely, X-ray of the knee and CT of the hip joint. Antibacterial therapy was started as well.