Osteomielitis

OST E O M Y E L I T I S
AYUNDA NOVITA SARI

DEFINITION
Osteomyelitis is a serious infection of the bone that can be acute or chronic. It

is an inflammatory process involving the bones and their structures caused by
pyogenic organisms that spread through the bloodstream, fractures, or surgery.
CLASSIFICATION
acute and subacute: chronic (suppurative and

Acute can come from hematogenous nonsuppurative):
origin, it is said to be acute if it occurs Suppuration is most often caused by
within 2 weeks. Sub-acute transitional bacteria, in this case pus, fistulas and
stage of acute osteomyelitis that sequesters are often found.
occurs in the third and fourth weeks Nonsuppurative due to inadequate
after the onset of symptoms. treatment or due to antibiotic
resistance.
ETIOLOGY
Risk factors for osteomyelitis
Risk factor
include a weak immune system,
and various medical conditions.
Staphylococcus aureus attaches to bone
Such as diabetes, sickle cell
by expressing receptors, called adhesins,
for several bone matrix components, anemia, HIV/AIDS, or
including laminin, collagen, fibronectin, rheumatoid arthritis
and bone sialoglycoprotein.
PATHOPHYSIOLOGY
METHOD
establish a diagnosis
Symptoms: joint pain, swelling, difficulty moving, stiffness, fever? Is there a clicking
sound?
Look: deformity (+), edema (+), hyperemia (+) feel: tenderness, warmth movement:
painful / limited ROM
Complete blood: leukocytosis X-Ray: tissue swelling, involucrum (+), sequestrum (+)
GOVERNANCE
• Refer to Sp.OT
• IUFD calls lactate
• Cefriaxone injection 2gr/24 hours
• ketorolac injection 30 mg/ 24 hours
• surgery
DIFFERENTIAL DIAGNOSIS
The differential diagnosis of osteomyelitis is broad, and it is important to keep this in mind
during the evaluation of patients suspected of having bone infection. These differences
include:
• Charcot arthropathy especially in diabetics
• SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis and osteitis)
• Arthritis includes rheumatoid arthritis
• Metastatic bone disease
• Fractures, including pathological and stress fractures.
• Gout
• Avascular necrosis of bone
• Inflammation of the mucous membrane
• Sickle cell vaso-occlusive pain crisis
complications
Early treatment, including antibiotic therapy, is
EDUCATION necessary to prevent complications from developing.

Some complications that may arise from untreated or
inadequately treated osteomyelitis are:
Patient education regarding the
• Septic arthritis
prolonged nature of therapy and the
• Pathological fracture
need for compliance with treatment
• Squamous cell carcinoma
recommendations to ensure adequate
• Formation of sinus tract
wound healing thereby reducing the
• Amyloidosis (rare)
risk of recurrence is an important part
• Abscess
of care in these patients.
• Bone deformity
• Systemic infection
• Adjacent soft tissue infection
CONCLUSION
With aggressive early treatment, the prognosis for acute osteomyelitis is good. However, it is
possible that the infection may recur years after successful treatment if there is new trauma to
the same area or if the body's immunity is weakened. In adults, the recurrence rate of chronic
osteomyelitis is approximately 30% within 12 months, but in cases involving P. aeruginosa, the
recurrence rate may be as high as 50%. Cases involving prosthetic devices are more difficult to
treat, leading to increased morbidity due to the need for more surgical procedures and the
longer course of antibiotics required for treatment. Measures used to prevent post-operative
infections include good pre-operative preparation whenever possible and the use of a surgical
suite with laminar air flow. It is also recommended to use preoperative prophylactic antibiotic
treatment administered parenterally 30 minutes before skin incision with a first generation
cephalosporin (cefazolin) or a second generation cephalosporin (cefuroxime). All of these
measures have been shown to reduce postoperative infection rates from 0.5% to 2%, thereby
improving patient outcomes
REFERENCE
1.Schmitt SK. Osteomyelitis. Infect Dis Clin North Am. June 2017; 31(2):325-338. [ PubMed ]
2.Lew DP, Waldvogel FA. Osteomielitis. N Engl J Med. 03 April 1997; 336(14): 999-1007 . [ PubMed ]
3.Rubin RJ, Harrington CA, Poon A, Dietrich K, Greene JA, Moiduddin A. Economic impact of
Staphylococcus aureus infections in New York City hospitals. Dis infection appears. 1999 Jan-February;
5(1):9-17. [ PMC free article ] [ PubMed ]
4. Kremers HM, Nwojo ME, Ransom JE, Wood-Wentz CM, Melton LJ, Huddleston PM. Trends in the
epidemiology of osteomyelitis: a population-based study, 1969 to 2009. J Bone Joint Surg Am. May 20, 2015;
97 (10):837-45. [ PMC free article ] [ PubMed ]
5.Hatzenbuehler J, Pulling TJ. Diagnosis and management of osteomyelitis. I'm a Family Doctor. 01
November 2011; 84 (9):1027-33.[ PubMed ]
6.Zimmerli W. Clinical practice. Spinal osteomyelitis. N Engl J Med. 18 March 2010; 362 (11):1022-9.
[ PubMed ]
7.Berbari EF, Kanj SS, Kowalski TJ, Darouiche RO, Widmer AF, Schmitt SK, Hendershot EF, Holtom PD,
Huddleston PM, Petermann GW, Osmon DR, Infectious Diseases Society of America 2015 Infectious
Diseases Society of America (IDSA) Clinical Practice Guidelines ) for the Diagnosis and Treatment of
Genuine Vertebral Osteomyelitis in Adults. Clinic Infect Dis. September 15, 2015; 61(6):e26-46. [ PubMed ]

Osteomielitis

Uploaded by

Copyright:

Available Formats

Osteomielitis

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Osteomielitis

Uploaded by

Copyright:

Available Formats

OST E O M Y E L I T I S

AYUNDA NOVITA SARI

Osteomyelitis is a serious infection of the bone that can be acute or chronic. It

acute and subacute: chronic (suppurative and

EDUCATION necessary to prevent complications from developing.

You might also like