This 2009 narrative review by Copley examines how the rise of community-acquired MRSA has transformed pediatric musculoskeletal infection into a more complex, multifocal disease — and asks what evaluation strategies and antibiotic regimens should now guide management.
When you see a child with fever, bone pain, and elevated CRP — especially if >8 years old in a high-MRSA community — think multifocal disease, get MRI early to map all infection foci, empirically start clindamycin rather than a cephalosporin, and actively screen for DVT if CRP exceeds 6 mg/dL. Use CRP ≤2 mg/dL as your discharge threshold and ESR normalization to determine when to stop antibiotics.
This 2009 narrative review by Copley examines how the rise of community-acquired MRSA has transformed pediatric musculoskeletal infection into a more complex, multifocal disease — and asks what evaluation strategies and antibiotic regimens should now guide management.
When you see a child with fever, bone pain, and elevated CRP — especially if >8 years old in a high-MRSA community — think multifocal disease, get MRI early to map all infection foci, empirically start clindamycin rather than a cephalosporin, and actively screen for DVT if CRP exceeds 6 mg/dL. Use CRP ≤2 mg/dL as your discharge threshold and ESR normalization to determine when to stop antibiotics.