PAEDIATRIC ACUTE HAEMATOGENOUS OSTEOMYELITIS: A 15-YEAR REVIEW IN SOUTHERN NEW ZEALAND

Introduction New Zealand has high rates of pediatric acute hematogenous osteomyelitis (AHO); however, data has reflected large scale studies of North Island populations alone. The aim of this study is to record the incidence of the disease, diagnosis, management and barriers to care specific to the southern region. Methods A fifteen-year retrospective review of children aged 6 weeks to 15 years admitted with Pediatric AHO at Southland and Dunedin Hospitals from 2008 to 2022. Demographics, features of presentation, diagnosis, management, and complications were recorded. Data were compared to published data from the national tertiary centre, Starship Hospital. Results Ninety-eight cases met the inclusion criteria. On average, there were six admissions per year. Males are overrepresented (N=62, 64%). Mean age at presentation was 7.2 years. Mean length of stay was 7 days. MRI was used to diagnose 72% of cases. Diagnosis was made within the first 24hours of admission in 50% of cases. Methicillin sensitive Staphylococcus aureus was the detected organism in 32% of cases. MRSA was not detected in any cases. Two children were transferred to the Starship Intensive Care Unit (2%). There were no deaths. Mean antibiotic duration was 38 days. Twenty-nine children (30%) had surgery. Two children had pathologic fractures, two had recurrence and one had leg length discrepancy. Discussion Compared to the northern data, presenting features of acute osteomyelitis are similar; Māori and Pacific Island children are not as grossly overrepresented and MRI for diagnosis is common. Duration of antibiotic therapy is shorter. Overall, the disease burden is lower with less surgery, shorter length of stay, no recorded MRSA and <5% developing long-term sequelae of disease.