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Presence of Group A Streptococcus infection
4%
147/4023
Presence of Coliforms infection
2%
74/4023
Presence of Haemophilus infection
1%
24/4023
Presence of Pseudomonas infection
91%
3674/4023
Presence of Group B Streptococcus infection
87/4023
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Calcaneal osteomyelitis in children can occur via hematogenous seeding or direct puncture wounds. There are 2 types of pediatric hematogenous osteomyelitis: acute(AHO) and subacute hematogenous (SHO). The most common organism idenitified is Stapylococcus Aureus according to Blyth et al and is found in 70% of the cases. The article by Karwowska et al reviewed 146 osteomyelitis cases and noted that tenderness was the most common sign while fever and decreased limb use were the most common symptoms. Miller's review states that Group A streptococcus and Coliforms were less common organisms and with recent immunization programs, Haemophilus influenzae is almost eradicated as an osteomyelitis etiology. However, the etiology of calcaneal osteomyelitis due to puncture wounds is different. The article by Puffinbarger et al found a 100% incidence of Pseuodomonas infection in their calcaneal osteomyelitis cases caused by puncture wounds, as in this patient's case.
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