Advances in the diagnosis and management of pediatric osteomyelitis.

Acute hematogenous osteomyelitis is a common disease that affects previously healthy children of all age groups. Despite its importance, there are limited data in the current literature to guide many aspects of the diagnosis and therapy of this infection. Over the last decade, our understanding of the etiology of this infection has changed, with increased recognition of Kingella kingae and the dramatic increase in community-associated Methicillin-resistant Staphylococcus aureus (CA-MRSA) infections. There is a need for the optimization of diagnostic strategies, such as MRI and serum inflammatory markers. Several recent studies have examined treatment strategies, including a rapid transition to oral antimicrobial therapy and a shortened overall course of therapy. Many new therapeutic options are on the horizon that will likely impact the management of this and other childhood bacterial infections. This review summarizes recent investigations into the optimal diagnosis and management of acute hematogenous osteomyelitis in children.