Clinical characteristics of neonatal and infant osteomyelitis and septic arthritis: a multicenter retrospective study

J Pediatr (Rio J). 2024 Jul-Aug;100(4):430-437. doi: 10.1016/j.jped.2024.03.003. Epub 2024 Apr 17.


Objective: Signs and symptoms of osteomyelitis or septic arthritis in neonates and infants are often nonspecific and early-stage bone infections in infants may often go unnoticed. The objective of this study was to analyze the clinical characteristics of newborns and infants with osteomyelitis and septic arthritis to improve understanding of the disorder and to assist clinicians with diagnosis.

Methods: A retrospective multicenter study was conducted on neonates (0-28 days old, n = 94) and infants (1-12 months old, n = 415) with osteoarticular infections. Data consisting of clinical characteristics, complications, laboratory outcomes, and the pathogenic microorganisms causing osteomyelitis were tabulated. The statistics were further broken down into two regions and the significant differences between neonates and infants were evaluated and compared to the literature.

Results: Compared to infants, neonates had significantly lower incidences of fever (p < 0.0001), higher incidences of localized swelling (p = 0.0021), higher rate of infection at the humerus (p = 0.0016), higher percentage of Escherichia coli (p < 0.0001) and Klebsiella pneumoniae (p = 0.0039) infections, lower percentage of Staphylococcus aureus infections (p < 0.0001) and were more likely to develop septic arthritis (p < 0.0001).

Conclusion: Distinct differences were found between neonatal and infants with osteoarticular infections. Future studies should focus on improving diagnosis and subsequent treatment regimens for younger age groups.

Keywords: Clinical characteristics; Infants; Neonates; Osteomyelitis; Septic arthritis.

Publication types

  • Multicenter Study

MeSH terms

  • Arthritis, Infectious* / diagnosis
  • Arthritis, Infectious* / microbiology
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Osteomyelitis* / diagnosis
  • Osteomyelitis* / microbiology
  • Retrospective Studies
  • Staphylococcal Infections