Nelson Textbook of Pediatrics 22nd Edition | Fastidious gram-negative coccobacillus, normal flora of oropharynx. Leading cause of osteomyelitis, septic arthritis, spondylodiscitis, bacteremia in children 6-48 months. Often culture-negative; diagnosis by PCR. Treatment: cephalosporins (cefazolin, ceftriaxone), penicillin (if β-lactamase negative).
🌐 paeds.online — Pakistan's Pediatric Platform| Condition | Age | Presentation | Key Points |
|---|---|---|---|
| Septic arthritis (most common) | 6-48 months (peak 12-24 months) | Mild symptoms, low-grade fever (or afebrile), normal or mildly elevated CRP/WBC, often <50,000 WBC in synovial fluid； hip or knee常见 | Gram stain often negative; PCR essential； usually mild course |
| Osteomyelitis | 6-48 months | Insidious onset, limp, refusal to bear weight, mild pain, often afebrile； metaphyseal lesions | May be subacute; MRI shows bone marrow edema; PCR from bone biopsy or blood |
| Spondylodiscitis | <4 years | Back pain, refusal to sit/walk, limp, abdominal pain | MRI shows disk space narrowing; PCR from blood or oropharynx (if compatible) |
| Occult bacteremia | 6-48 months | Fever without focus, well-appearing, normal CRP/WBC often | Self-limited; treat if persistent or high risk |
| Endocarditis | Older children (rare) | Fever, murmur, embolic phenomena; often pre-existing heart disease | High mortality; surgical intervention often needed |