Reflections on so-called culture-negative osteoarticular infections in pediatric populations

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Osteoarticular infections (OAIs) in children can significantly affect bone growth and joint function, with many cases remaining culture-negative.
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Subacute hematogenous osteomyelitis (SAHO) is often under-recognized, presenting with mild symptoms and positive imaging but negative cultures.
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PCR-based diagnostic methods have improved pathogen identification rates in OAIs, revealing Kingella kingae as a leading cause in children under 4.
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Culture-negative OAIs may be due to unrecognized fastidious organisms, indicating a need for further research and improved diagnostic techniques.
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The oropharyngeal microbiota is a primary source of pathogens in pediatric OAIs, highlighting the importance of understanding microbial ecosystems.

Frontiers In Pediatrics

by Ahmer Ahmad Khan, Giacomo De Marco, Elio Paris, Oscar Vazquez, Christina Steiger-Tuk, Romain Dayer, Dimitri Ceroni
May 11, 2026

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