Guidelines
Osteomyelitis/Septic Arthritis

Osteomyelitis/Septic Arthritis

Clinical/Diagnostic Recommendations

  • If septic arthritis, diagnostic arthrocentesis is recommended.
  • Send joint or fluid aspirates for culture. Joint aspirates can also be held for possible molecular diagnostics.
  • Blood cultures (2 sets prior to antimicrobials).
  • Consider MRI for diagnosis of osteomyelitis if not typical presentation.
  • Lyme disease possible if subacute monoarthritis (see section on Lyme disease).

Infection Prevention and Control

Routine Practices

Droplet Precautions

If Haemophilus influenzae type b suspected

In non immune child < 5 years of age, maintain precautions until 24 hours of appropriate antimicrobial therapy received

Most Likely Pathogens

Kingella kingae

Most common in children < 4 years old

Less common

Empiric Antimicrobials

If Cultures Positive for MSSA

If Cultures Positive for GAS

Usual Duration

3 - 4 weeks for osteomyelitis including conversion to PO when appropriate

3 - 4 weeks recommended for septic arthritis.

Most clinicians recommend 4 - 6 weeks for hip septic arthritis

Consult ID