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ALL / Rheumatology
Osteomyelitis
Osteomyelitis
Osteomyelitis describes an infection of the bone. It may be subclassified into:- haematogenous osteomyelitis
- results from bacteraemia
- is usually monomicrobial
- most common form in children
- vertebral osteomyelitis is the most common form of haematogenous osteomyelitis in adults
- risk factors include: sickle cell anaemia, intravenous drug user, immunosuppression due to either medication or HIV, infective endocarditis
- non-haematogenous osteomyelitis:
- results from the contiguous spread of infection from adjacent soft tissues to the bone or from direct injury/trauma to bone
- is often polymicrobial
- most common form in adults
- risk factors include: diabetic foot ulcers/pressure sores, diabetes mellitus, peripheral arterial disease
Microbiology
- Staph. aureus is the most common cause except in patients with sickle-cell anaemia where Salmonella species predominate
Investigations
- MRI is the imaging modality of choice, with a sensitivity of 90-100%
Management
- flucloxacillin for 6 weeks
- clindamycin if penicillin-allergic
+PassMedicine Notes
Osteomyelitis describes an infection of the bone. It may be subclassified into:
- haematogenous osteomyelitis
- results from bacteraemia
- is usually monomicrobial
- most common form in children
- vertebral osteomyelitis is the most common form of haematogenous osteomyelitis in adults
- risk factors include: sickle cell anaemia, intravenous drug user, immunosuppression due to either medication or HIV, infective endocarditis
- non-haematogenous osteomyelitis:
- results from the contiguous spread of infection from adjacent soft tissues to the bone or from direct injury/trauma to bone
- is often polymicrobial
- most common form in adults
- risk factors include: diabetic foot ulcers/pressure sores, diabetes mellitus, peripheral arterial disease
- Staph. aureus is the most common cause except in patients with sickle-cell anaemia where Salmonella species predominate
- MRI is the imaging modality of choice, with a sensitivity of 90-100%
- flucloxacillin for 6 weeks
- clindamycin if penicillin-allergic
