Pneumococcal osteomyelitis and arthritis in children. A hospital series and literature review
N. M. Jacobs
Department of Pediatrics, Cook County Hospital, Chicago, IL 60612.
Twenty-nine children with pneumococcal osteomyelitis and/or arthritis, 11
of whom had osteomyelitis, were treated at Cook County Hospital, Chicago,
Ill, in the past 20 years. They were mostly normal children with a single
focus of infection. They represented more than 5% of the hospitalized
children with a systemic pneumococcal infection. Most of the pneumococcal
isolates were serotyped; serotype 19, in particular, seemed to be unusually
common in these children. Twenty-three of the 29 children with pneumococcal
osteomyelitis and/or arthritis had been hospitalized in the past 15 years.
These 23 children were compared with 161 hospitalized children who had bone
and joint infections with other isolated bacteria. The children with
pneumococcal osteomyelitis and/or arthritis were indistinguishable from
most of the other children, except by age. All but three of the children
with pneumococcal osteomyelitis and/or arthritis were between the ages of 3
and 24 months. In this age group, Pneumococcus was the common isolate from
children with osteomyelitis, and second only to Haemophilus influenzae from
children with bacterial arthritis. Pneumococcal osteomyelitis and/or
arthritis has never been rare; the medical literature describes at least
245 other children, most of whom were younger than 2 years.
