Osteomyelitis simply means an infection of the bone or bone marrow. It can be usefully subclassified on the basis of the causative organism (pyogenic bacteria or mycobacteria), the route, duration and anatomic location of the infection.
In general, microorganisms may infect bone through one or more of three basic methods: via the bloodstream, contiguously from local areas of infection (as in cellulitis), or penetrating trauma, including iatrogenic causes such as joint replacements or internal fixation of fractures or root-canaled teeth. Also, once intracellular, the bacteria are able to escape and invade other bone cells.
In addition, once intracellular, the bacteria becomes resistant to antibiotics. These combined facts may explain the chronicity and difficult eradication of this disease. This results in significant costs and disability and may even lead to amputation. Intracellular existence of bacteria in osteomyelitis is likely an unrecognized contributing factor to its chronic form.
In infants, the infection can spread to the joint and cause arthritis. In children, large subperiosteal abscesses can form because the periosteum is loosely attached to the surface of the bone. Abscesses of any bone, however, may be precipitated by trauma to the affected area.
Many infections are caused by ''Staphylococcus aureus'', a member of the normal flora found on the skin and mucous membranes. In sickle cell the causative agent is normally from the Salmonella species.
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Last Updated: Sep 15, 2014