Pediatric osteomyelitis in Panama.

Two hundred forty-one children who had osteomyelitis during a 19-year period, 1974 through 1992, were identified by chart review. Acute osteomyelitis or chronic osteomyelitis was the diagnosis for 221 (92%) and 20 (8%) of the children, respectively. Bacteriologic etiology was documented in 137 (57%) of the cases. Staphylococcus aureus, Pseudomonas aeruginosa, Salmonella species organisms, and Haemophilus influenzae type b were isolated from 97 (40%), 10 (4%), 8 (3%), and 7 (3%) of the children, respectively. S. aureus was the predominant microorganism in all age groups, whereas H. influenzae occurred only in children younger than 2 years of age. P. aeruginosa was recovered predominantly from children with a penetrating injury of the foot, while salmonella bone infections were diagnosed in patients with sickle cell disease. These data provide guidelines for the initial work-up for and management of osteomyelitis in children living in developing Latin American countries.