Osteomyelitis

Lew, Daniel Pablo; Waldvogel, Francis

doi:10.1056/nejm199704033361406

Cited by 627 publications

(385 citation statements)

References 54 publications

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“…[15][16][17][18] Therapy for four to six weeks has been reported to achieve an acceptable rate of cure. [15][16][17][18][19][20] The cost of intravenous antibiotics at home for six weeks can range from US$3500 to US$10 000. 21 The rate of serious complications from the use of intravenous catheters ranges from 10% to 30%.…”

Section: -11mentioning

confidence: 99%

A comparison of short- and long-term intravenous antibiotic therapy in the postoperative management of adult osteomyelitis

Swiontkowski¹,

Hanel

Vedder

et al. 1999

The Journal of Bone and Joint Surgery. British volume

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T he current standard recommendation for antibiotic therapy in the management of chronic osteomyelitis is intravenous treatment for six weeks. We have compared this regime with short-term intravenous therapy followed by oral dosage.A total of 93 patients, with chronic osteomyelitis, underwent single-stage, aggressive surgical debridement and appropriate soft-tissue coverage. Culture-specific intravenous antibiotics were given for five to seven days, followed by oral therapy for six weeks. During surgery, the scar, including the sinus track, was excised en bloc. We used a high-speed, saline-cooled burr to remove necrotic bone, and osseous laser Doppler flowmetry to ensure that the remaining bone was viable. Infected nonunions (Cierny stage-IV osteomyelitis) were stabilised by internal fixation. In 38 patients management of dead space required antibiotic-impregnated polymethylmethacrylate beads, which were exchanged for an autogenous bone graft at six weeks. Free-tissue transfer often facilitated soft-tissue coverage. These 93 patients were compared with 22 consecutive patients treated previously who had the same surgical management, but received culture-specific intravenous antibiotics for six weeks.Of the 93 patients, 80 healed without further intervention. Of the 31 Cierny-IV lesions, 27 healed without another operation, and four fractures required additional bone grafts. No more wound drainage was needed. Treatment was successful in 91% of patients, regardless of the organism involved. There was no difference in outcome in terms of these variables when the series were compared. We conclude that the long-term administration of intravenous antibiotics is not necessary to achieve a high rate of clinical resolution of wound drainage for adult patients with chronic osteomyelitis.

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Section: -11mentioning

confidence: 99%

A comparison of short- and long-term intravenous antibiotic therapy in the postoperative management of adult osteomyelitis

Swiontkowski¹,

Hanel

Vedder

et al. 1999

The Journal of Bone and Joint Surgery. British volume

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“…Staphylococcus aureus is the most common pathogenic organism causing H O , although Streptococci, gram-negative enteric organisms, and anaerobic bacteria have also been linked to the disease (Lew and Waldvogel, 1997;Beckles et al, 2010;Al Hajry et al, 2012). Infection typically occurs in children, and is commonly caused by invasion of the richly vascularized metaphyseal region of the tibia, femur, or humerus by a single microorganism (Claro et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Association of single nucleotide polymorphisms in pro-inflammatory cytokine and toll-like receptor genes with pediatric hematogenous osteomyelitis

et al. 2016

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ABSTRACT. Hematogenous osteomyelitis (H O ) is a bone infectionwherein bacteria penetrate to the bone through the blood stream. Several single nucleotide polymorphisms (SNPs) have been associated with susceptibility to infectious diseases. In this study, we investigated the contribution of SNPs in interleukin (IL)-1B1 (rs16944), IL1A (rs1800587), IL1B (rs1143634), toll-like receptor (TLR)-2 (rs3804099), TLR4 (rs4986790), TLR4 (rs4986791), IL1R (rs2234650), tumor necrosis factor (TNF)-α (rs1800629), TNF (rs361525), and IL1RN (rs315952) towards the development of H O in Saudi patients and compared to healthy controls. Fifty-two patients diagnosed with H O and 103 healthy individuals were genotyped. The frequencies of genotypes GG (rs16944) and AA (rs16944) were lower and higher in patients [odds ratio (OR) = 0.34, Pc = 0.05] and controls (OR = 1.33, Pc = 0.05), respectively, suggesting that SNPs at this locus could alter H O susceptibility. In addition, the patients and controls exhibited lower and higher frequencies of the alleles G (rs16944) (OR = 0.43, Pc = 0.007) and A (rs16944) (OR = 2.32, Pc = 0.007), respectively. The expression of alleles C (rs3804099) and T (rs3804099) were higher in patients (OR = 2.05, Pc = 0.04) and controls (OR = 0.49, Pc = 0.04), respectively. In conclusion, SNPs at rs16944 and rs3804099 were found to be associated with H O in the Saudi population.

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“…The causative pathogens in osteomyelitis vary according to the age of the patientas well as the clinical situation. Staphylococcus aureus is responsible for majority of cases of acute hematogenous osteomyelitis in children [15,16] . Acute hematogenous osteomyelitis is treated with a parenteral course of antibiotics for four to six weeks [15] .…”

Section: Discussionmentioning

confidence: 99%

Isolated chronic osteomyelitis of fibula in a child: A case report and review of literature

Singh¹,

Kalia²,

Virk³

2017

Int. J. Orthop. Sci.

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Introduction: Osteomyelitis is one of the oldest diseases known. Hematogenous osteomyelitis is common in metaphysis of long bones like tibia and femur. Isolated osteomyelitis of fibula in diaphyseal region is un common and has been rarely reported. Case Presentation: 8 year old male child presented to us with discharging sinus and granulation tissue over lower lateral aspect of left leg. He had a history of trauma 8 months back and had an open wound at the site of injury. The patient kept on doing daily dressings but was not relieved. The patient developed acute pain at the site of injury accompanied with fever and chills and was referred to us. We did sequestrectomy along with debridement and excision of sinus tract followed by a course of intravenous and oral antibiotics. At 12 months follow up, patient is completely symptom free and ambulating with full weight bearing on the affected leg. Conclusion: Our case reports describes a rare case of isolated osteomyelitis of fibula in a child which occurred secondary to trauma and highlights the importance of a multi-discliplinary approach to deal with osteomyelitis.

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Osteomyelitis

Cited by 627 publications

References 54 publications

A comparison of short- and long-term intravenous antibiotic therapy in the postoperative management of adult osteomyelitis

A comparison of short- and long-term intravenous antibiotic therapy in the postoperative management of adult osteomyelitis

Association of single nucleotide polymorphisms in pro-inflammatory cytokine and toll-like receptor genes with pediatric hematogenous osteomyelitis

Isolated chronic osteomyelitis of fibula in a child: A case report and review of literature

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