Aetiology of osteomyelitis in children

The most likely cause of osteomyelitis varies depending on the age of the child, duration of the illness, anatomical location and the presence of underlying disease (eg sickle cell disease, immunodeficiency)Gigante 2019

In children older than 1 year, Staphylococcus aureus is the most common pathogen identified. Consider risk factors for infection with methicillin-resistant strains.

In infants and children younger than 4 years, Kingella kingae is an increasingly recognised cause of osteomyelitis and should be considered when routine cultures are negative. It is likely under recognised.

Haemophilus influenzae type b (Hib) can cause acute osteomyelitis in children younger than 5 years who are not fully vaccinated against H. influenzae type b.