Osteomyelitis (pediatrics) Quiz: Ace Your Exams
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A 3-year-old boy is brought to the emergency department with fever and lethargy. His parents report that he has been refusing to walk for the past two days and has become increasingly irritable. He has no significant past medical history. His temperature is 39.2°C (102.6°F), blood pressure is 85/50 mmHg, heart rate is 145 beats per minute, respiratory rate is 30 breaths per minute, and oxygen saturation is 97% on room air. On examination, he appears ill and lethargic. The right thigh is swollen, warm, and tender to palpation. Laboratory results are displayed below, and blood cultures are pending. Radiographs of the femur reveal soft tissue swelling but no fracture or lytic lesions. Which of the following is the best next step in management?
| Laboratory Test | Result |
| White blood cell count | 18,500/mm³ |
| Hemoglobin | 11.8 g/dL |
| Platelets | 420,000/mm³ |
| C-reactive protein (CRP) | 12.5 mg/dL |
| Erythrocyte sedimentation rate (ESR) | 65 mm/hr |
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