Osteomyelitis - Schoenwald

Question 1

What are the sources of osteomyelitis

Answer 1

Hematogenous spread
Invasion from a contiguous focus of infxn (like diabetic foot wound)
Skin breakdown (from vascular insufficiency or trauma)

Question 2

What leads to hematogenous spread induced osteomyelitis

Answer 2

Bacteremia

Question 3

What are risk factors for hematogenous spread

Answer 3

Sickle Cell
Elderly
IV drug user
Diabetes (or any state of weakened immune system)
Kidney failure
Joint replacement/hardware placement
Peripheral neuropathy
Peripheral vascular disease

Question 4

What is the common causative organism associated with osteomyelitis in pts with sickle cell

Answer 4

salmonella

Question 5

What is the most common organism associated with osteomyelitis in IV drug users

Answer 5

S. aureus

Question 6

What are the most common sx associated with osteomyelitis

Answer 6

Fever (may be absent or low grade)
Bone or joint tenderness/pain (unless pt is neuropathic)
Elevated acute phase reactants

Question 7

What are signs that should give you a high suspicion for osteomyelitis

Answer 7

Bone can be probed with swab from wound site

Wound >6 weeks in duration