Subacute epiphyseal osteomyelitis of the distal tibia in children report of a case and review of the literature

We report a 5-year-old girl with subacute osteomyelitis of the distal tibial epiphysis. Failure to respond to a 2-week course of intravenous antibiotic therapy and the close proximity of the lesion to the growth plate necessitated surgical debridement. Culture of the aspirated serous fluid identified the causative organism to be Streptococcus salivarius. Surgery was followed by a full course of intravenous and oral antibiotics. The patient was clinically and radiologically well three years after surgery, without any damage to the epiphyseal growth plate. A literature review of 40 similar cases provides an update on the current management of epiphyseal osteomyelitis in children.