Osteomyelitis

The progression of disease in localized osteomyelitis is characterized by a cycle of microbial invasion, vascular disruption, necrosis and sequestration. The host inflammatory response, discussed in detail below, results in obstruction of small vessels due to coagulopathy and oedema. As a result of this, cortical bone undergoes necrosis and is detached from surrounding live bone, creating an area known as a sequestrum. This provides a fertile environment for further bacterial invasion and progression continues.

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Contiguous-Focus Osteomyelitis Even when diagnosed early, contiguous-focus osteomyelitis usually requires surgery in addition to 4–6 weeks of appropriate antibiotic therapy because of underlying soft tissue infection or damage to bone from an injury or surgery. A 2-week course of antibiotics after thorough debridement and soft tissue coverage has yielded adequate results in the treatment of superficial osteomyelitis involving only the outer cortex of bone.

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Harrison's Internal Medicine Chapter 120. Osteomyelitis Osteomyelitis: Introduction Osteomyelitis, an infection of bone, is caused most commonly by pyogenic bacteria and mycobacteria. As a useful framework for evaluating a patient and planning treatment, cases are classified on the basis of the causative agent; the route by which organisms gain access to bone; the duration of infection; the anatomic location of infection; and the local and systemic host factors that have a bearing on pathogenesis and outcome.

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Vertebral Osteomyelitis The vertebrae are the most common sites of hematogenous osteomyelitis in adults. Organisms reach the well-perfused vertebral body via spinal arteries and quickly spread from the end plate into the disk space and then to the adjacent vertebral body. Sources of bacteremia include the urinary tract (especially among men over age 50), dental abscesses, soft tissue infections, and contaminated IV lines, but the source of bacteremia is not evident in more than half of patients.

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Microbiology S. aureus is a pathogen in more than half of cases of contiguous-focus osteomyelitis. However, in contrast to hematogenous osteomyelitis, these infections are often polymicrobial and are more likely to involve gram-negative and anaerobic bacteria. Hence a mixture of staphylococci, streptococci, enteric organisms, and anaerobic bacteria may be isolated from a diabetic foot infection or pelvic osteomyelitis underlying a decubitus ulcer.

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Osteomyelitis of the thoracic spine demonstrated on a sagittal, fatsuppressed T1-weighted magnetic resonance image after the administration of IV gadolinium. At T8–T9, there is involvement of the adjacent vertebral bodies and intervening disk. Abnormally enhancing inflammatory tissue extends from the disk space anteriorly (white arrow) as well as posteriorly into the epidural space, compressing the thecal sac (black arrow).

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Table 120-2 Selection of Antibiotics for Treatment of Acute Osteomyelitis Suggested Regimena Organism Primary Alternativesb Staphylococcus aureus Penicillin- Nafcillin or oxacillin, 2 g Cefazolin, 1 g IV resistant, methicillin- IV q4h q8h; ceftriaxone, 1 g IV q24h; clindamycin, 900 mg IV q8hc sensitive (MSSA) Penicillinsensitive Penicillin, 3–4 million U IV q4h Cefazolin, ceftriaxone, clindamycin (as above) Methicillinresistant (MRSA) Vancomycin, 15 mg/kg Clindamycinc (as IV q12h; rifampin, 300 mg PO above); linezolid, 600 q12h (see text) mg IV or PO q12hd; daptomyci...

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Tham khảo sách 'osteomyelitis edited by mauricio s. baptista and joão paulo tardivo', y tế - sức khoẻ, y học thường thức phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả

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The pathogenesis of osteomyelitis is a complex process involving interactions between a host and an infectious agent. The host’s inflammatory response to a pathogen can further the physical spread of disease by clearing space in bone. Predisposing genetic differences in immune function are increasingly seen as an aetiological factor in some cases of osteomyelitis. Acquired factors such as diseases causing immune or vascular compromise and implantation of foreign materials are frequently involved in the disease process as well. ...

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Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Successful treatment of Mycobacterium ulcerans osteomyelitis with minor surgical debridement and prolonged rifampicin and ciprofloxacin therapy: a case report

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Specific therapy is ultimately based on in vitro susceptibility testing of the organism(s) isolated from bone or blood. Outpatient parenteral antimicrobial therapy (OPAT) is appropriate for motivated and medically stable patients and represents a significant advance in management. Antibiotics that require infrequent dosing, such as ceftriaxone, ertapenem, daptomycin, and vancomycin, may facilitate home therapy, but these choices often have an overly broad spectrum of activity.

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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Chronic nonbacterial osteomyelitis in childhood: prospective follow-up during the first year of anti-inflammatory treatment...

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Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Vertebral osteomyelitis and native valve endocarditis due to Staphylococcus simulans: a case report

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Osteomyelitis, an infection of bone, is caused most commonly by pyogenic bacteria and mycobacteria. As a useful framework for evaluating a patient and planning treatment, cases are classified on the basis of the causative agent; the route by which organisms gain access to bone; the duration of infection; the anatomic location of infection; and the local and systemic host factors that have a bearing on pathogenesis and outcome. Pathogenesis and Pathology Microorganisms enter bone by hematogenous dissemination, by spread from a contiguous focus of infection, or by a penetrating wound.

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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Hyperbaric oxygen therapy as an adjunctive treatment for sternal infection and osteomyelitis after sternotomy and cardiothoracic surgery...

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Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Arthritis, osteomyelitis, septicemia and meningitis caused by Klebsiella in a low-birth-weight newborn: a case report....

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Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Granulomatous pyoderma preceding chronic recurrent multifocal osteomyelitis triggered by vaccinations in a two-year-old boy: a case report

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Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài:Hodgkin’s lymphoma masquerading as vertebral osteomyelitis in a man with diabetes: a case report

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Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Retraction: A novel observation of pubic osteomyelitis due to Streptococcus viridans after dental extraction: a case report

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Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: A novel observation of pubic osteomyelitis due to Streptococcus viridans after dental extraction: a case report

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