Severe infection of bone, bone marrow, and surrounding soft tissue.
osteomyelitis
What is the most common microorganism that causes osteomyelitis?
staph. aureus
- but can be caused by a variety of organisms
What is the etiology of osteomyelitis?
-indirect (hematogenous) or direct entry
What is the pathophysiology of osteomyelitis?
- microorganisms grow—>
- increases pressure in bone —>
- ischemia and vascular compromise —>
- infection spreads through bone —>
- cortex devascularization and necrosis
What are the clinical manifestations of acute osteomyelitis maning infection of <1 month in duration?
Local manifestations:
-constant bone pain that worsens with activity, unrelieved by rest
Systemic manifestations:
fever, night sweats, chills, nausea, decreased WBC and malaise
What are the long term and rare complications of osteomyelitis?
septicemia
septic arthritis
pathologic fractures
amyloidosis
What are the diagnostic studies associated with osteomyelitis?
- bone or soft tissue biopsy
- blood and/or wound cultures
- WBC count
- erythrocyte sedimentation rate (ESR)
- c reactive protein
- X-rays/MRI/CT scans
- bone scans
What is the treatment for osteomyelitis?
- aggressive prolonged IV antibiotics therapy (4-6 weeks or longer)
- culture or bone biopsy to determine antibiotic
- surgical debridement and decompression
What is the care for chronic osteomyelitis?
- surgical removal
- extended use of antibiotics
- impregnated antibiotic beads
- intermittent or constant antibiotic irrigation of bone
- casts or braces
- negative pressure or hyperbaric wound therapy
- removal of prosthetic devices
- amputation: if bone destruction is extensive
Who is at risk for osteomyelitis?
- immunocompromised pt’s
- diabetics
- pt’s with prosthetics
- pt’s with vascular insufficiencies
