osteomyelitis
OSTEOMYELITIS
Osteomyelitis is an acute or chronic inflammation of the bone due to an infection resulting from hematogenous spread, contiguous spread from soft tissues and joints to bone, or direct inoculation into bone from surgery or trauma.
The infection is generally due to a single microorganism but polymicrobial infections may also occur.
Staphylococcus aureus is a major cause of infection.
Signs and symptoms include fever; inflammatory findings of erythema, warmth, pain and swelling over the involved area; draining sinus tracts over affected bone; limited movement of affected extremity; pain in the chest, back, abdomen or leg, and tenderness over involved vertebrae in patients with vertebral osteomyelitis; anorexia, vomiting and malaise.

Surgical Intervention

  • Indications include persistent fever, erythema, pain & swelling, bacteremia, abscess or sinus tract formation, presence of necrotic bone, & failure to improve after 48-72 hr of antimicrobial therapy
  • Long-bone osteomyelitis is classified into stages based on the magnitude of infection; these stages may be used to guide the type of surgical intervention needed
    • Stage 1 (medullary) often requires unroofing & intramedullary reaming
    • Stage 2 (superficial) often requires superficial debridement, coverage & possibly ablation
    • Stage 3 (localized) often needs debridement, dead space management, temporary stabilization & bone grafting
    • Stage 4 (diffuse) often needs stabilization through open reduction w/ internal or external fixation in addition to procedures required for Stage 3
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Infectious Diseases - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
15 Nov 2017
New drug applications approved by US FDA as of 1 - 15 November 2017 which includes New Molecular Entities (NMEs) and new biologics. It does not include Tentative Approvals. Supplemental approvals may have occurred since the original approval date.
29 Oct 2017
There is insufficient evidence to support the exclusive use of azole therapies for leishmaniasis, as itraconazole, ketoconazole and fluconazole all have similar but modest efficacy rates, according to a new meta-analysis.