Osteomyelitis in pediatric patients with leukemia

An 11‐year retrospective study showed that there were nine patients with osteomyelitis in our population of pediatric patients with leukemia. Six patients had acute lymphoblastic leukemia (ALL) and three had acute nonlymphoblastic leukemia (ANLL). Seven of nine patients were in remission at the time of diagnosis of osteomyelitis. The delay in diagnosis, which exceeded 2 weeks in seven patients, was typical. Surgical intervention was required for diagnostic or therapeutic purposes in five patients. Staphylococcus aureus was isolated from only three patients. Informative diagnostic studies included nuclear scans that yielded abnormal results in all patients and erythrocyte sedimentation rates (ESR) that were elevated to greater than 70 mm/h in seven patients. The recognition of features that differ from osteomyelitis in the normal population may facilitate earlier diagnosis.