In children, bone infections acquired through the bloodstream cause fever and, sometimes days later, pain in the infected bone. The area over the bone may be sore and swollen, and movement may be painful.

Infections of the vertebrae usually develop gradually, producing persistent back pain and tenderness when touched. Pain worsens with movement and isn't relieved by resting, applying heat, or taking analgesics. Fever, the usual sign of an infection, is often absent.

Bone infections resulting from infections in adjacent soft tissues or direct invasion cause pain and swelling in the area over the bone; abscesses may form in the surrounding tissue. These infections may not cause fever, and blood test results may be normal. A person who has an infected artificial joint or limb usually has persistent pain in that area.

If a bone infection isn't treated successfully, chronic osteomyelitis may develop. Sometimes, this type of infection is undetectable for a long time, producing no symptoms for months or years. More commonly, chronic osteomyelitis causes bone pain, recurring infections in the soft tissue over the bone, and constant or intermittent drainage of pus through the skin. Drainage occurs when pus from the infected bone breaks through the skin's surface and a passage (sinus tract) forms from the bone to the skin.

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