Galluzzo et al identified clinical findings in a child with osteomyelitis which may help identify chronic granulomatous disease (CGD). The authors are from Hospital Nacional de Pediatria J.P. Garrahan in Buenos Aires.
Patient selection: child with osteomyelitis
Clinical findings:
(1) multifocal osteomyelitis
(2) involvement of other organs
(3) Serratia marcescens or Aspergillus species isolated on culture
(4) bone biopsy at a focus of osteomyelitis shows chronic inflammation with necrosis, granulomas and/or multinucleated giant cells
where:
• The spectrum of bacteria and fungi associated with CGD is broader and includes Candida, Nocardia, and uncommon Gram negative rods (see Chapter 03). Staphylococcus aureus, Streptococcus and Salmonella may also be involved but can occur in patients without CGD.
• A history of recurrent infections could also be a clue.
The presence of one or more of these factors should prompt consideration of CGD.
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