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.
Further Reading
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"Osteomyelitis"
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