Osteomyelitis in children is a potentially serious condition and have potential for lifelong disability and morbidity. The early diagnosis and appropriate treatment is critically important. The common causative organisms for chronic osteomyelitis are staphylococcus aureus, streptococci, H influenza and salmonella. In children with sickle cell anaemia the most common organisms are salmonella. The collection of appropriate sample like discharging pus or even bone sampling for microbiological and pathological examination may allow choosing the most effective antibiotics. Methicillin resistant S.aureus which earlier used to be considered as nosocomial infection is increasingly being identified in community acquired infections. We present here a case of acute osteomyelitis caused by methicillin resistant staphylococcus aureus. The patient was a 8 year old male child with no significant past medical history was admitted with complaints of heel pain and inability to bear weight on affected limb since 4-6 weeks. Patient earlier took treatment from local physician who prescribed some oral medicine. There was no improvement in the pain and at the time of presentation to our institute the patient had more definitive signs of infection including fever and local tenderness and a discharging sinus. An MRI was done which revealed features of osteomyelitis in the form of sequester and soft tissue gas. Since the history was that of more than 1 month a diagnosis of chronic osteomyelitis was made and the discharging pus was sent for microbiological examination which showed growth of methicillin resistant staphylococcus aureus sensitive to linezolid. Patient was successfully treated with linezolide in appropriate doses.

Our case emphasise the importance of proper investigations (Imaging, microbiological and pathological examinations) and treatment with appropriate antibiotics in patients suspected to be having osteomyelitis.

Keywords: Chronic osteomyelitis, Methicillin Resistant Staphylococcus aureus, Linezolid, Computed Tomography.