Osteomyelitis

Question 1

what are the organisms for acute bone infections?

Answer 1

• G+: Staph aureus, Group A Strep

- G-: Salmonella, Neisseria gonorrhoeae

Question 2

what are the organisms for chronic bone infections?

Answer 2

Mycobacterium, melioidosis (Burkholderia)

Question 3

What are clinical features of acute osteomyelitis?

Answer 3

• Onset of symptoms over several days
• Dull pain with or without movement
• Local findings, e.g. tenderness, warmth, erythema, swelling
• Possibly systemic symptoms, e.g. fever, rigors
• Possibly septic arthritis

Question 4

What are the features of chronic osteomyelitis?

Answer 4

• Pain, erythema, swelling
• Presence of a draining sinus tract (passage from infected bone to skin surface, through which pus drains) is pathognomonic
• Deep or extensive ulcers that fail to heal

Question 5

what is the management of osteomyelitis?

Answer 5

• Chronic osteomyelitis (months-years): Associated with avascular necrosis (AVN), formation of sequestrum (dead bone) –> surgical debridement and antibiotic therapy are both indicated
• Acute osteomyelitis (days-weeks) –> Can respond to antibiotics alone