Osteomyelitis (pediatrics) Quiz: Ace Your Exams
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A 7-year-old girl is brought to the emergency department with fever and worsening right leg pain for the past five days. Her parent reports that she fell off her bicycle one week ago, scraping her right leg, but they did not seek medical attention at the time. Since then, she has been increasingly irritable, refusing to bear weight, and experiencing persistent leg pain even at rest. The patient’s temperature is 39°C (102.2°F), blood pressure is 105/65 mmHg, heart rate is 135 beats per minute, respiratory rate is 22 breaths per minute, and oxygen saturation is 99% on room air. The right lower leg is swollen, warm, and tender to palpation, with limited range of motion due to pain. A scab is present over the right shin. Laboratory results are shown below. Magnetic resonance imaging (MRI) of the right leg reveals bone marrow edema and a subperiosteal abscess measuring 3.5 cm in diameter. Which of the following is the best next step in management?
| Laboratory Test | Result | Reference Range |
| White blood cell count | 19,200/mm³ | 4,300-11,400/mm³ |
| Hemoglobin | 12.0 g/dL | 11.5-15.5 g/dL |
| Platelets | 450,000/mm³ | 150,000-450,000/mm³ |
| C-reactive protein (CRP) | 14.8 mg/dL | <1 mg/dL |
| Erythrocyte sedimentation rate (ESR) | 72 mm/hr | 1-20 mm/hr |
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