Because of their increasing frequency in all types of infection, Candida species may be seen more often in bone infections. Treatment of these infections is difficult, and therapy needs to be individualized against the specific organism. Leukocytosis may be present. A decreased range of motion and signs of local infection may be seen in the affected area. Drainage is not usually seen.
Blood cultures are positive in more than half of patients.
Although in most children symptoms are present for 3 weeks or less, some children may present with vague symptoms of 1 to 3 months' duration. Vertebral osteomyelitis is a form of hematogenous osteomyelitis most commonly seen in older persons and I.V. drug abusers. Most patients present with a constant dull pain that progresses slowly. Percussion over the affected area usually causes intense pain. Neurologic signs are generally absent but when present may indicate an epidural abscess.