Osteomielitis Akut: Dr. Dani Rosdiana, SPPD Bagian Ilmu Penyakit Dalam FK Universitas Riau

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OSTEOMIELITIS AKUT

dr. Dani Rosdiana, SpPD


Bagian Ilmu Penyakit Dalam
FK Universitas Riau
LATAR BELAKANG
Osteomielitis: peradangan tulang caused by
organism infection.
Kejadian : paling banyak pada anak-anak
(predominantly)
Dewasa: sering sub akut atau kronik
Trauma, pembedahan, benda asing pada trauma,
prothesa disrupt bony integrity
Penjalaran hematogen post bacteriemia.
prosthetic joints are associated with infection,
microorganisms typically grow in biofilm, which
protects bacteria from antimicrobial treatment
and the host immune response.
INSIDENSI
Hematogenous >> (20%), lebih banyak pada
laki-laki (why? Unknown)
Insidensi spinal osteomyelitis diperkirakan 1
in 450,000 pada 2001. namun, overall
incidence vertebral osteomyelitis diperkirakan
akan terus meningkat tahun terakhir karena:
intravenous drug use
increasing age of the population
higher rates of nosocomial infection due to
intravascular devices and other
instrumentation.
Etiology
Post traumatic osteomyelitis :47% cases
Other major causes :
Vascular insufficiency (mostly occurring in
persons with diabetes; 34%)
Hematogenous seeding (19%).
Motor vehicle accidents, sports injuries, and the
use of orthopedic hardware to manage trauma.
Osteomyelitis may complicate puncture wounds
of the foot, occurring in 1.8%-6.4% of patients
following injury.
Osteomielitis Hematogen
Vertebrae : paling banyak terkena
hematogenous osteomyelitis,
Long bones, pelvis, and clavicle.
Microba:
S aureus : paling banyak Osteomielitis AKUT
Pseudomonas
Enterobacteriaceae.
Jarang: anaerobe gram-negative bacilli.
Dental extraction has been associated with
Streptococcus viridans infections .
Osteomielitis Kronik
TAMPILAN KLINIK
GEJALA
Demam, menggigil, lelah, lemah.
Gejala klasik peradangan : nyeri lokal,
bengkak, merah, dan kadang hilang dalam
waktu 5-7 hari.
Need to explore: previous antibiotic and
surgical treatment. Local pain, swelling,
erythema, and edema may also be
reported.
PHYSICAL EXAMINATION
Scars or local disturbance of wound
healing may be noted along with the
cardinal signs of inflammation.
Range of motion, deformity, and local
signs of impaired
Vascularity are also sought in the
involved extremity.
If periosteal tissues are involved, point
tenderness may be present.

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