Pediatric chronic osteomyelitis in the outskirts of Al-Ushbuna (Carnide, Lisboa, Portugal)

Abstract

The skeletal remains of seven individuals (five non-adults and two adults) were recovered during an archeological intervention in the township of Carnide (Lisbon, Portugal). Funerary anthropology strongly suggests that the sample is from the Medieval Islamic period (8th - 12th centuries AD). This report presents a case of chronic osteomyelitis in a non-adult individual. The diagnostic is substantiated by the presence of pathognomonic signs of osteomyelitis, including the presence of cloacae and a sequestrum in the left tibia. The bone infection is discussed in the context of inadequate socioeconomic conditions. This case from a relatively unfamiliar chronology and cultural context supplements the uncommon paleopathological descriptions of osteomyelitis in non-adults from historical populations.

Pediatric mandibular osteomyelitis: a probable case from Okhotsk period (5th–13th century AD) northern Japan

“…While OM is considered to have been a relatively common condition in the past, especially among non-adult individuals (Baltensperger and Eyrich, 2009b;Santos and Suby, 2015;Roberts, 2019), it is rarely reported in the paleopathological literature (Tavares et al, 2017;Lewis, 2018;Roberts, 2019). Tavares and colleagues (2017) identified only ten published cases of pediatric OM, and a handful of others (e.g., Anderson and Carter, 1995;Ortner, 2003;Waters-Rist, 2012;Lewis, 2018) can be added to this list.…”

“…OM, a bone and marrow infection most commonly affecting children, can be difficult to diagnose from archaeological human remains (Tavares et al, 2017;Lewis, 2018;Roberts, 2019). The condition may present with diverse and even nonspecific skeletal lesions reflecting variation in its manifestation (e.g., acute/subacute versus chronic, or suppurative versus non-suppurative) or infection source (Aufderheide and Rodríguez-Martín, 1998;Ortner, 2003;Suei et al, 2005;Baltensperger and Eyrich, 2009a, b;Lewis, 2018;Roberts, 2019).…”

“…In paleopathology, in particular, pathognomonic lesions such as sequestra, involucra, and cloacae are not always present on skeletal remains. As a result, few archaeological cases of OM have been published, despite the general understanding of the condition as a relatively common and serious health complication in the past (Baltensperger and Eyrich, 2009b;Santos and Suby, 2015;Tavares et al, 2017;Lewis, 2018;Roberts, 2019). A thorough documentation of OM prevalence, presentation, and distribution in archaeological and early historical contexts that pre-date the use of antibiotic therapies is paramount to understanding the evolution and long-term impact of the disease (Santos and Suby, 2015).…”