Staphylococcus aureus costal osteomyelitis complicated by pleural effusion in a 7-month-old infant: a misleading clinical presentation

Abstract

Osteomyelitis is an inflammation of the bone, generally of infectious origin. It often affects the long bones, but the clinical presentation can be misleading if the location is atypical. Costal osteomyelitis is very rare in children and can mimic other pathologies. We report the case of a 7-month-old male infant with no previous medical history who was admitted for investigation of acute fever, incessant crying and a parietal chest mass. The biology showed an inflammatory syndrome. Chest X-ray showed left pleural effusion and the CT scan showed lesions compatible with the diagnosis of costal osteomyelitis complicated by a rupture of the subperiosteal abscess in the pleura. The evolution was favorable after chest drain insertion of the pleurisy and intravenous antibiotic therapy. Costal osteomyelitis is a very rare condition that can mislead the clinician. Early recognition and proper treatment can prevent complications.