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| {{Infobox Disease | | |||
| Name = Osteomyelitis | | |||
| Image = | | |||
| Caption = | | |||
| ICD10 = {{ICD10|M|86||m|86}} | | |||
| ICD9 = {{ICD9|730}} | | |||
| ICDO = | | |||
| OMIM = | | |||
| DiseasesDB = 9367 | | |||
| MedlinePlus = 000437 | | |||
| eMedicineSubj = ped | | |||
| eMedicineTopic = 1677 | | |||
| MeshName = Osteomyelitis | | |||
| MeshNumber = C01.539.160.495 | | |||
| }} | |||
| '''Osteomyelitis''' is an ] of ], usually caused by ] ] or ]. It can be usefully subclassifed on the basis of the causative organism, the route, duration and anatomic location of the infection. | |||
| ==Presentation== | |||
| Generally microorganisms may be disseminated to bone hematogenously (''i.e.'', via the blood stream), spread contiguously to bone from local areas of infection, such as ], or be introduced by penetrating ] including ] causes such as joint replacements or internal fixation of fractures. ]s then enter the infected area, and in their attempt to ] the infectious organisms, release enzymes that lyse bone. ] spreads into the bone's blood vessels, impairing the flow, and areas of devitalized infected bone, known as '']'', form the basis of a chronic infection. On ] examination, these areas of necrotic bone are the basis for distinguishing between ''acute osteomyelitis'' and ''chronic osteomyelitis''. Osteomyelitis is an infective process which encompasses all of the bone (osseous) components, including the bone marrow. When it is chronic it can lead to bone sclerosis and deformity. | |||
| Because of the particulars of their blood supply, the ], the ], the ], and the ]l bodies are especially prone to osteomyelitis. | |||
| ==Etiology== | |||
| Acute osteomyelitis almost invariably occurs in children. when adults are affected it may be because of compromised host resistance due to debilitation, intravenous drug abuse, disease or drugs (e.g. ] therapy). | |||
| ==Treatment== | |||
| Osteomyelitis often requires prolonged ] therapy, lasting a matter of weeks or months, and may require surgical ]. Severe cases may lead to the loss of a limb. Initial first line antibiotics is determined by the patient's history and regional differences of common infective organisms. For example, in a 1 year old child, it would be appropriate to start a combination of Flucloxacillin and Fusidic Acid. | |||
| ==Causes== | |||
| The vast predominance of hematogenously seeded osteomyelitis is caused by '']''. '']'', and '']'' are other common ]s. In some subpopulations, including intravenous drug users and ] patients, ] bacteria, including enteric bacilli, are significant pathogens. | |||
| ''Staphylococcus aureus'' is also the most uncommon organism seen in osteomyelitis seeded from areas of contiguous infection, but here Gram negative organisms and ]s are somewhat more common, and mixed infections may be seen. | |||
| In osteomyelitis involving the vertebral bodies, about half the cases are due to ''Staphylococcus aureus'', and the other half are due to ] (spread hematogenously from the ]s). Tubercular osteomyelitis of the spine was so common before the initiation of effective antitubercular therapy that it acquired a special name, '']'', by which it is sometimes still known. | |||
| ==References== | |||
| * {{MerckManual|5|54|b}} | |||
| * - ''Statistics on Osteomyelitis in England | |||
| * {{Chorus|00298}} | |||
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Revision as of 04:15, 13 September 2006
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