Penicillin-resistant streptococcus pneumoniae [pneumococcus] osteomyelitis in a premature infant

We present an extremely rare occurrence of penicillin-resistant Streptococcus pneumonia osteomyelitis infection in a four-month-old premature infant. The baby presented with swelling of the thigh and low-grade fever. The X-ray of the leg was suggestive of fracture of the femur, while the ultrasonography revealed a periosteal reaction suggestive of osteomyelitis of the bone. Aspiration of the pus confirmed the presence of penicillin-resistant streptococcus pneumonia. The infection was managed with intravenous Cefepime for three weeks followed by another three weeks of oral Augmentin; the infant had good clinical and radiographic recovery