Acute (haematogenous) osteomyelitis of the skull in childhood.

A 13-year old boy presented with a 2-week history of right frontotemporal headache, fever and progressive painful swelling in that region. There was no preceding trauma. Clinical and radiological evaluation confirmed osteomyelitis of the right frontal bone. Staphylococcus aureus was found to be the causative organism. The affected bone was debrided and appropriate antibiotics administered. A subdural abscess developed requiring drainage. Hospital stay was 8 weeks. Haematogenous (pyogenic) osteomyelitis of the skull is rare in childhood and diagnosis may be missed or delayed. A high index of suspicion is necessary to make an early diagnosis and to avoid morbidity and mortality.