A 3-week-old term infant presents with fever, swelling over the distal humerus, and reduced limb movement. Blood culture grows an organism other than Staphylococcus aureus. Which organism is the next most likely cause of osteomyelitis in this age group?

• A Mycobacterium tuberculosis
• B Kingella kingae
• C Salmonella typhi
• D Group B Streptococcus ✓

Explanation

In neonates, group B Streptococcus and gram-negative bacilli such as Escherichia coli are the leading pathogens after Staphylococcus aureus, acquired during passage through the birth canal. Kingella kingae matters in children between six months and four years, not neonates. Salmonella is associated with sickle cell disease. Multifocal involvement is common in this age group because the transphyseal vessels are still patent.

Reference: Tachdjian's Pediatric Orthopedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.