Osteomyeliitin

Osteomyeliitin, the Estonian term for osteomyelitis, is an infection of bone and bone marrow. Most cases are bacterial, though fungal infections can occur, particularly in people with compromised immune systems. The condition can present as acute osteomyeliitin or chronic osteomyeliitin. It may arise by hematogenous spread, by infection spreading from adjacent tissue, or by direct inoculation after trauma or surgery.

In children, the long bones near the growth plates are commonly affected; in adults, vertebrae, the feet, hips, or areas with vascular disease are common. Risk factors include diabetes, peripheral vascular disease, immune suppression, intravenous drug use, and recent bone surgery.

Symptoms include bone pain, swelling, warmth, fever, and malaise; in chronic cases, persistent pain, drainage, or sinus tracts may be present.

Diagnosis relies on inflammatory markers (CRP and ESR), white blood cell counts, and imaging. X-rays may be normal early, while MRI is highly sensitive. Blood cultures and a bone biopsy or aspirate help identify the organism and guide therapy.

Treatment involves prolonged antibiotics, usually starting with IV therapy and continuing for several weeks, with adjustment based on organism and site. Surgical debridement or drainage of abscess and removal of necrotic bone or infected hardware may be required.

Prognosis improves with early, appropriate treatment but chronic infection and damage to bone or joints can occur. Prevention focuses on treating infections promptly, controlling risk factors such as diabetes, and adhering to sterile techniques in surgery.