Résumé

Introduction: atypical location of osteomyelitis is extremely rare and accounting for less than 1% of all hematogenous osteomyelitis in children. The diagnosis is usually challenging and made late, due to its rarity, nonspecific signs, and atypical organisms as long as bone osteomye-litis. In our context, treatment remains delayed and lengthy, with significant social repercus-sions. There are no consensual recommendations regarding their management. The objective was to describe our management strategy for atypical osteomyelitis in children, as well as the results of our treatment. Methodology: we conducted a retrospective descriptive monocentric study of children from 0 to 16 years old treated for atypical osteomyelitis location at our paediatric surgery department between 2015 and 2020. Data were collected from patient medical records and included demo-graphic information, medical history, admission time, clinical, laboratory, and imaging data, treatment (antibiotics, surgery), length of hospital stay, postoperative care, and outcomes. Result: six patients (four boys and two girls, aged 1 month to 13 years) with eight confirmed cases of atypical osteomyelitis of the clavicle, scapula, hand, and ribs were included. The mean diagnostic delay was 38.5 days. All patients were presented at chronic stage, with clinical signs of inflammation; only three of them had biological inflammatory syndrome. Initial ultrasound revealed localized periosteal detachment in three cases (patients 3, 4, and 5). Bacteriological samples were positive in five patients. Staphylococcus aureus was found in two patients. Treat-ment consisted of intravenous antibiotics based on culture data combined with surgery (in four patients), which leads to good outcomes. Conclusion: Atypical osteomyelitis location in children is rare but exists. The lack of specific clinical signs as in long bone osteomyelitis leads to diagnosis delay. Specific targeted isolated germs antibiotics and surgery is a therapeutic option with good outcomes.

Mot-clés :

Atypical Osteomyelitis Location, Diagnosis, Treatment, Children, Paediatric Surgery