ObjectiveOsteomyelitis is a severe inflammation within the bone, bone marrow and surrounding soft tissue, that develops secondary to infection with microbial organisms. The objective of this article is to present an over view regarding the identification and management of osteomyelitis.
IntroductionOsteomyelitis is acute and chronic inflammatory process based upon the histopathological finding rather than duration of infection. Osteomyelitis occurring primarily in children and adolescents pathogenic micro-organism cause inflammation and infection of bone, which lead to osteomyelitis and signs appears after two weeks of infection (Figure 1) In chronic osteomyelitis necrotic bone is present and signs may not appear until six weeks of infection [1]. Osteomyelitis infection is based on open wound, haematogenous or direct bacterial inoculation inside bone [2]. Radio nuclides imagine have improved diagnostic accuracy and better orthopaedic techniques as well as use of some prophylactic regimens which help to minimize the risk of infection among osteomyelitis patient.
EtiologyBacterial Staphylococcus is common infection which causes an acute and chronic haematogenous osteomyelitis. Different types of pathogens among children are Type A streptococcus, Streptococcus pneumonia, Kingella kingae and Type B streptococcal infection is mainly occur in infants [3]. Streptococcus aureus is the common pathogen in bone among adults. Progressively, methicillinresistant Staphylococcus aureus is separated from patients with osteomyelitis [4]. Other persistent cases may be caused by adjacent infection, Pseudomonas aeruginosa, Escherichia coli and Staphylococcus epidermidis. Other reported cases of osteomyelitis are mycobacterial infections and fungal, these are rare and usually found in patients with weakened of body immunity [5].
PathogenesisOsteomyelitis may be occurring direct inoculation of causative organism in bone. Normal bone is highly resistant to infection occur in case of injury, trauma, and existence of foreign bodies [6]. Causative organism streptococcus aureus adhere to bone and expressing receptors for bone matrix. An insignificant skin infection emerge the serious infection such as sub-acute and acute bacterial endocarditic [7]. In children and adults, osteomyelitis mainly involves metaphysis of long bone, femur, proximal radius and hummers [8,9]. Penetrating injury and surgical contamination are the most common causes of direct inoculation osteomyelitis. Patent with severe vascular diseases often lead to osteomyelitis.
Clinical ManifestationOsteomyelitis of acute haematogenous results from bacterial growth of bone. Most of the Children are more prone to infection because of developing of meta-physeal regions of the long bones, rich in blood supply and more prone to slight trauma. Acute haematogenous osteomyelitis in children occur about one-half of all patients who are under five years [10]. Children usually came with the symptom of exist fever, irritability, local erythema, swelling in soft tissues and tenderness bo...