Variations in the bacteriologic composition and response to treatment of subperiosteal abscess (SPA) have been associated with patient age.1 Among 37 patients, most children under 9 years of age had drainage cultures negative for bacteria or recovered without surgery. In a small number, cultures obtained early in the treatment course were positive for only single aerobes. In contrast, patients 15 years of age or older all had positive cultures despite at least 3 days of antibiotics that were usually effective in vitro. Polymicrobial infections were the rule, including anaerobes in every case. In that series, the youngest patient with anaerobic isolates was 9 years of age. We describe a 4-year-old child with an SPA caused by mixed aerobic and anaerobic pathogens, a finding that bears on age-based therapeutic recommendations.
Report of a Case.
A 4-year-old boy had a fever and marked eyelid edema and proptosis of the left eye.