Bone infections

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Before we understand what Bone Infection is, let us know what Infection is: Infectionis the invasion of an organisms body tissues by disease-causing agents, their multiplication, and the reaction of host tissues to the infectious agents and the toxins they produce. Infection of the bone by microorganisms is called ‘Osteomyelitis.’

Osteomyelitis can be divided into two types:

  • (a) Acute Osteomyelitis
  • (b) Chronic Osteomyelitis

Acute Osteomyelitis:

Acute Osteomyelitis can be either primary (Hematogenous) often found in children or secondary (following an open fracture or bone operation).

Etiology : The most common pathogens in osteomyelitis depends on the patient's age. Staphylococcus aureus is the most common cause of acute and chronic hematogenous osteomyelitis in adults and children. Group A streptococcus, Streptococcus pneumonia, and Kingella Kingae are the next most common pathogens in children. Group B streptococcal infection occurs primarily in newborns.

Presenting Complaints: Pain & swelling at the end of the bone systemic features fever and Treatment includes Antibiotics.

  • (B )Chronic Osteomyelitis: Chronic Osteomyelitis is of three types:
  • Chronic Osteomyelitis secondary to acute osteomyelitis

  • (i)Chronic Osteomyelitis secondary to acute osteomyelitis
  • (ii)Garre’s Osteomyelitis
  • (iii)Brodie Abscess

Chronic Osteomyelitis secondary to acute osteomyelitis:

Chronic osteomyelitis from contiguous soft tissue infection is becoming more common because of the increasing prevalence of diabetic foot infections and peripheral vascular disease. Up to one-half of patients with diabetes develop peripheral neuropathy, which may reduce their awareness of wounds and increase the risk of unrecognised infections. Peripheral vascular disease, which is also common in patients with diabetes, reduces the body's healing response and contributes to chronically open wounds and subsequent soft tissue infection. These conditions may act synergistically to increase the risk of osteomyelitis in these patients significantly.

Garre’s Osteomyelitis:

Garre's sclerosing osteomyelitis is a specific type of chronic osteomyelitis that mainly affects children and young adults. This disease entity is well-described in dental literature and associated in common with an odontogenic infection resulting from dental caries. It begins with acute local pain, fever, and swelling. However, pain and fever, but fust form osseous enlargement persists. There would be no tenderness on deep palpation. It can be treated with broad-spectrum antibiotics sometimes.

Brodie Abscess:

A particular type of osteomyelitis in which body defence mechanisms have been able to contain the infection to create a chronic bone abscess containing pus or jelly-like granulation tissue surrounded by a zone of sclerosis. Clinical features: It’s between the age 11-20 years and causes deep, intense pain which found predominantly, the symptoms may become wore at on walking and heals by taking rest. Surgical evacuation and curettage can treat it under antibiotics covers.

Other forms of Bone Infection are as follows:

1.TB Osteomyelitis:

During this type of bone infection, the discharge is often thin and watery, Multifocal. The patient may suffer or had suffered from pulmonary tuberculosis

2. Salmonella Osteomyelitis:

It occurs during the convalescent phase after an attack of ‘typhoid fever’. Subacute type of Osteomyelitis which arises on multiple bones is sometimes affected bilaterally symmetrical, more common in children with sickle cell anaemia.

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