Introduction: The infection of a cephalohematoma is an infrequente but potentially fatal condition due to its possible complications such as osteomyelitis, meningitis or sepsis.

Case report: The report describes a newborn delivered by cesarean section, and a history of duodenal atresia with surgical correction, who develops, at 8 days of life, an infection of a cephalohematoma with sepsis and meningitis. After aspiration of the cephalohematoma and a three week course of antibiotics, she showed a favorable outcome.

Conclusion: When the infection of a cephalohematoma is suspected, its drainage is both a diagnostic and therapeutic tool, as antibiotic therapy alone is often insufficient. Possible complications such as meningitis, osteomyelitis and sepsis must be ruled out.

C. Cortés Ledesma. Departamento de Neonatología. Hospital General Universitario Gregorio Marañón. Dr. Esquerdo, 46. 28007 Madrid.
Correo electrónico: crispucortes@gmail.com

Pelvic osteomyelitis is a rare disease that represents between 6-8% of the cases of acute hematogenous osteomyelitis. It is more frequent in males, and its clinical presentation is variable and nonspecific, circumstances that contribute to delaying the diagnosis. There is no specific laboratory test to aid in the diagnosis, and patients with osteomyelitis often have negative cultures. Complications are unusual.

We report the case of a ten-year-old boy, whose medical history was unremarkable, with acute osteomyelitis of the left ischiopubic region, complicated by an abscess in adductor magnus muscle.

Osteomyelitis is the most frequent osteoarticular infection during childhood. Acute hematogenous osteomyelitis is the most common form of presentation. The subacute form, which usually affects the metaphysis of long bones, is less common, and its diagnosis can be complicated.

Brodie's abscess is a localized subacute hematogenous osteomyelitis, the incidence of which has increased in recent years. Due to the absence of a generalized infectious syndrome, the normal laboratory findings and the difficult radiological interpretation, it often is difficult to diagnose. Oral antibiotic therapy is the recommended approach, with surgical treatment being reserved for cases in which no response is obtained. We present the case of a 15-year-old boy diagnosed as having Brodie's abscess, with typical metaphyseal involvement, who did not respond to oral antibiotics and, thus, underwent surgical debridement.

We report a case of neonatal osteoarthritis in a 21-day-old girl who had required hospital admission at birth. This disease is uncommon in infants, but is of great importance because of the marked medium-term and long-term impact associated with delayed diagnosis and treatment. Therefore, this entity should not be overlooked in those newborns in whom there is clinical evidence, although nonspecific, of pain on joint movement or inexplicable crying, especially in those who have been subjected to hospital admission and those who have undergone techniques such as venipuncture. Early medical and/or surgical treatment improves the long-term results, reason for which it is so important.

Introduction: Though infrequent, intracranial complications of head and neck infections in children can have severe consequences if not diagnosed and treated early.

Methods: Review of patients with secondary intracraneal complications of head and neck infections diagnosed at a tertiary care hospital over a period of 4 years (2005-2009).

Results: There were five cases of intracraneal complications (three non-vascular and two vascular). The three non-vascular cases were: a) epidural abscess secondary to otomastoiditis; b) petrositis with sixth nerve palsy secondary to sphenoid sinusitis and otomastoiditis, and c) subperiostic orbital abscess fol­lowing ethmoid and sphenoid sinusitis. Only in the first case was the causal germ isolated in haemoculture (Streptococcus pyogenes). The first case required surgical evacuation, and all cases received prolonged parenteral antibiotherapy. The vascular complications comprised two cases of intracranial thrombosis of sinus sigmoid secondary to otomastoiditis. S. pyogenes was also found in the haemoculture of one case. In both patients, the procoagulant factors proved negative. One of the two cases was not put on anticoagulant therapy and rechannelling was partial, though it remained asymptomatic.

Conclusions: Knowing these complications will lead us to suspect them in the event of torpid and recurrent disease course, or appearance of related neurological symptomatology. In such cases, multidisciplinary medical-surgical management is required and on that sequelae and prognosis depend. As it is not risk-free, the use of anticoagulation in children with intracranial sinus thrombosis is controversial, and consequently, despite international recommendations, in each case individualised and consensus-based decisions often prevail.