Osteomyelitis is an infection of the bone that results from the spread of microorganisms from the blood (hematogenous), nearby infected tissue, or open wounds (non-hematogenous). Infections are most commonly caused by Staphylococcus aureus, but a variety of organisms have been linked to osteomyelitis. The majority of patients present with pain, redness, and swelling of the affected site, and may have associated symptoms such as fever and chills. Laboratory values will demonstrate elevated WBC, CRP, and erythrocyte sedimentation rate ( ESR ESR Soft Tissue Abscess) in most cases. The most sensitive and specific imaging modality to diagnose osteomyelitis is MRI. Management may require long-term antibiotics and potential surgical debridement Debridement The removal of foreign material and devitalized or contaminated tissue from or adjacent to a traumatic or infected lesion until surrounding healthy tissue is exposed. Stevens-Johnson Syndrome.
Last updated: Dec 5, 2022
Osteomyelitis is classified based on the route of infection.
Non-hematogenous osteomyelitis (80% of cases):
Hematogenous Hematogenous Hepatocellular Carcinoma (HCC) and Liver Metastases osteomyelitis (20% of cases):
|Risk factors||Infectious agents|
|No specific risk factor||S. aureus S. aureus Potentially pathogenic bacteria found in nasal membranes, skin, hair follicles, and perineum of warm-blooded animals. They may cause a wide range of infections and intoxications. Staphylococcus|
|Prosthetic joint replacement Prosthetic Joint Replacement Septic Arthritis||
|Sickle cell anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types||
|Chronic granulomatous disease Granulomatous disease A defect of leukocyte function in which phagocytic cells ingest but fail to digest bacteria, resulting in recurring bacterial infections with granuloma formation. When chronic granulomatous disease is caused by mutations in the cybb gene, the condition is inherited in an X-linked recessive pattern. When chronic granulomatous disease is caused by cyba, ncf1, ncf2, or ncf4 gene mutations, the condition is inherited in an autosomal recessive pattern. Common Variable Immunodeficiency (CVID)||
|Sexually active, no other risk factors||N. gonorrhoeae N. gonorrhoeae A species of gram-negative, aerobic bacteria primarily found in purulent venereal discharges. It is the causative agent of gonorrhea. Neisseria (more likely to cause septic arthritis Septic arthritis Septic arthritis is an infection of the joint due to direct inoculation, contiguous extension, or hematogenous spread of infectious organisms into the joint space. This process causes an acute, inflammatory, monoarticular arthritis. Septic Arthritis than osteomyelitis)|
|Cat or dog bite||Pasteurella multocida Pasteurella multocida A species of gram-negative, facultatively anaerobic, rod-shaped bacteria normally found in the flora of the mouth and respiratory tract of animals and birds. It causes shipping fever; hemorrhagic bacteremia; and intestinal disease in animals. In humans, disease usually arises from a wound infection following a bite or scratch from domesticated animals. Dog and Cat Bites|
|IV drug use or immunocompromised immunocompromised A human or animal whose immunologic mechanism is deficient because of an immunodeficiency disorder or other disease or as the result of the administration of immunosuppressive drugs or radiation. Gastroenteritis||
Osteomyelitis is an infection of the bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Bones: Structure and Types that results from hematogenous Hematogenous Hepatocellular Carcinoma (HCC) and Liver Metastases or non-hematogenous spread of infectious organisms.
Sternoclavicular and pelvic osteomyelitis:
Long bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Bones: Structure and Types osteomyelitis:
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