Osteomielitis en el hueso temporal asociado a miositis suprayacente por Streptococcus Pyogenes en un Recién Nacido Osteomyelitis of the Temporal Bone Associated with Overlying Myositis due to Streptococcus pyogenes Infection in a Newborn

Introduction: Osteomyelitis of the skull in the newborn is an uncommon disease that is generally triggered by risk factors. Microorganisms involved are usually those of the vaginal canal. Case Report: We present the case of a newborn without perinatal risk factors delivered vaginally without complications. At 22 days postpartum the child presented with fever, irritability, and swelling in the left retroauricular area. Laboratory tests showed leukocytosis, toxic granulation, and band. Magnetic resonance reported a thick-walled pseudo-nodule with fluid signal at the center; the image was associated with a break in the adjacent bone. Puncture was performed of the swollen area producing a purulent fluid from which group A â-hemolytic streptococcus was isolated. Treatment was begun with intravenous ampicillin for 7 days and upon a sharp reduction of PCR (196 mg/dL to 48 mg/dL) was continued for 2 weeks, with oral amoxicillin. The patient's progress was satisfactory without sequelae. Discussion: The patient presented no known risk factors and we hypothesize that bone infection by Streptococcus pyogenes was hematogenous. Magnetic resonance imaging provided information of high value in the diagnosis. We found no mention in the literature of osteomyelitis of the skull caused by Streptococcus pyogenes in newborns, which we report as a new finding.