Chronic osteomyelitis a risk factor for fibromyalgia
Patients with chronic osteomyelitis may be predisposed to developing fibromyalgia, a study suggests. However, the risk may be attenuated by rigorous treatments for chronic osteomyelitis, especially in younger patients.
Researchers examined data from 1,244 chronic osteomyelitis patients without fibromyalgia and 4,976 randomly selected sex- and age-matched controls without the medical conditions. Fibromyalgia incidence was estimated over a follow-up period of 13 years using the Cox proportional regression model.
The risk of fibromyalgia was significantly higher among patients with chronic osteomyelitis than among controls. Risk factors for fibromyalgia—including hypertension, hyperlipidaemia, diabetes, sleep disorder, depression and anxiety—were also much more common in the chronic osteomyelitis group.
Patients with chronic osteomyelitis were 1.32 (95 percent CI, 0.99 to 1.75) times as likely as controls to develop fibromyalgia.
The risk of developing fibromyalgia further increased in the subgroup of chronic osteomyelitis patients who were aged <35 years (adjusted hazard ratio [HR] 1.58; 1.03 to 2.44) but not in the subgroup of those who were aged ≥60 years (adjusted HR, 1.03; 0.78 to 1.36).
The findings suggest that chronic osteomyelitis predicts fibromyalgia, highlighting the importance of close monitoring of patients with condition in order to prevent fibromyalgia, particularly in younger populations.
Chronic osteomyelitis is an infection of the bone, which is not caused by acute haematogenous seeding or penetrating injury. It commonly occurs by contiguous spread and has been present for several weeks. Current recommendations cite the use of antibiotic therapy for 6 to 12 weeks. Evidence suggests that oral therapy may be a more attractive option than parenteral therapy as the former is generally cheaper and avoids risks associated with intravenous catheters. [Clin Infect Dis 2012;54:393-407]