Osteomyelitis in an infants: BCG or Pyogenic Infection?

Abstract

Osteomyelitis is a rare but potentially serious bone infection in infants. This case report presents a 5-week-old infant with limited range of motion and left shoulder pain of two weeks' duration. Initially diagnosed as a brachial plexus injury, detailed assessment on a second visit revealed signs of local inflammation and radiological findings consistent with osteomyelitis of the proximal humerus. The differential diagnosis included pyogenic osteomyelitis and a possible complication of the BCG vaccine given at birth. The patient was treated empirically with intravenous antibiotics, with a good clinical outcome and a decrease in inflammatory markers. This case highlights the importance of considering all possible aetiologies in the diagnosis of osteomyelitis in infants, including rare post-vaccinal complications. The combination of careful clinical assessment, imaging studies and microbiological cultures is essential for accurate diagnosis. Appropriate and timely management is essential to prevent long-term complications in this vulnerable population.