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Pediatric osteomyelitis occurs often following a hematogenous spread of bacteria that seeds the sluggish metaphyseal venous sinusoids. The diagnosis can be confirmed with a combination of physical exam, laboratory tests, and imaging studies. Treatment algorithms vary but it is generally agreed upon that if a patient has worsening physical exam findings, lab tests, and imaging studies following a trial of antibiotics for 48 hours, surgical decompression is indicated. If purulence collects below t
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