Systemic Infection of Pediatric Osteomyelitis: A Clinical Case in a Low-Income Country

Osteomyelitis is a severe bone infection that requires early diagnosis and targeted treatment, mainly in pediatric populations where clinical presentations can be complex and nonspecific. This case report presents a seven-year-old male from Los Ríos, Santo Domingo, Dominican Republic, diagnosed with methicillin-resistant Staphylococcus aureus (MRSA)-associated osteomyelitis. The child presented with systemic signs, including fever, vomiting, and abdominal pain, along with localized trauma, limb pain, and functional limitations. Clinical examination revealed hemodynamic instability and gastrointestinal involvement, while laboratory findings indicated infection and malnutrition. Imaging confirmed osteomyelitis in the left femur and periosteal injury in the right forearm. Blood and soft tissue cultures identified MRSA as the causative agent. This case highlights the importance of early imaging, microbial isolation, and a multidisciplinary approach in the management of pediatric osteomyelitis, such as intravenous antibiotics, monitoring, and long-term medications. It also underscores the need for increased awareness and diagnostic capabilities in developing countries to facilitate timely intervention and reduce long-term complications.