Osteomyelitis: A Descriptive Study

Abstract

BackgroundTo analyze the incidence and clinical-microbiological characteristics of osteomyelitis (OM) in a tertiary Spanish hospital.MethodsAll cases diagnosed with OM between January 2007 and December 2010 were retrospectively reviewed. The variables examined include epidemiological characteristics, risk factors, affected bone, radiographic changes, histology, microbiological culture results, antibiotic treatment, and the need for surgery.ResultsSixty-three cases of OM were diagnosed. Twenty-six patients (41.3%) had acute OM whereas 37 patients (58.7%) were classified as chronic OM. OM may result from haematogenous or contiguous microbial seeding. In this group, 49 patients (77.8%) presented with OM secondary to a contiguous source of infection and 14 patients had hematogenous OM (22.2%). Staphylococcus aureus was the most commonly found microorganism.ConclusionsOM mainly affected patients with risk factors related to the presence of vascular diseases. Antibiotic treatment must be guided by susceptibility patterns of individual microorganisms, although it must be performed together with surgery in most of the cases.

Free intra-osseous muscle transfer for treatment of chronic osteomyelitis

“…Diagnosis of chronic osteomyelitis was based on both clinical assessment and physical examination, along with chronic pain, wound drainage, blood cultures, histology, and radiographic examinations [7,8]. Osteomyelitis was located at the femur in four patients, the tibia in 22 patients, and the foot in three patients.…”

Clinical and Laboratory Diagnosis

“…Conversely, chronic osteomyelitis frequency increases with age. Generally, patients under 18 years of age are more likely to have hematogenous osteomyelitis unless otherwise indicated [ 9 ]. On the contrary, bacteremia in adults rarely results in osteomyelitis, and secondary spread from a contiguous focus of infection, such as from surgical wounds or ulcerations, are more common.…”

“…Populations of hospitalized patients with a history of previous ulceration and infection have a higher prevalence of osteomyelitis than nondiabetic patients with open wounds seen in an outpatient ambulatory care clinic. In one study, 87.3 % of all hospitalized patients diagnosed with osteomyelitis had a previous history of trauma or skin infection [ 9 ]. But with all this considered, risk factors although helpful in gaining clinical suspicion, cannot be utilized as the sole diagnostic tool for lower extremity osteomyelitis.…”

“…A severe bone fracture or a deep puncture wound provides organisms a portal of entry into osseous structures or nearby soft tissues. In particular, surgical correction following open trauma involving osseous or articular surfaces increases patient risk in developing osteomyelitis [ 9 ].…”

An effective treatment of experimental osteomyelitis using the antimicrobial titanium/silver-containing nHP66 (nano-hydroxyapatite/polyamide-66) nanoscaffold biomaterials

“…However, effective treatment of chronic osteomyelitis using antimicrobial agents remains a significant clinical challenge1314. Furthermore, increasing numbers of osteomyelitis cases are caused by multiple infections or multi-drug resistant bacterial strains such as methicillin-resistant Staphylococcus aureus (MRSA), and possess even more formidable clinical challenges151617. Thus, there is an unmet clinical need to develop novel and effective strategies to combat osteomyelitis.…”