Acute hematogenous osteomyelitis of the epiphysis.

Acute primary infection of the epiphysis is uncommon. This article presents 2 cases. An acute osteomyelitis of the distal femoral epiphysis, which was not diagnosed until 2 weeks after the onset of symptoms, developed in a 4-year-old boy. The epiphyseal infection spread into the knee joint, necessitating surgical debridement. An acute osteomyelitis of the proximal tibial epiphysis developed in a 23-month-old girl. Although the diagnosis was not confirmed until 1 week after the onset of symptoms, she responded well to a course of intravenous antibiotics followed by oral antibiotics. The epiphysis is a potential site for acute hematogenous osteomyelitis. Prompt diagnosis and early treatment may prevent spread of the infection into the adjacent joint.