Osteomyelit

Osteomyelit, or osteomyelitis, is an infection of bone and bone marrow. It can arise when bacteria reach bone through the bloodstream (hematogenous spread), from nearby infected tissue, or after an injury or surgery. It can involve any bone but most commonly affects long bones in children and the spine in adults.

Classification distinguishes acute from chronic disease. Acute osteomyelitis develops over days to weeks and may be hematogenous or due to contiguous infection; chronic disease persists for months and may involve sequestrum formation. The most common pathogen worldwide is Staphylococcus aureus, with other bacteria including streptococci and Gram-negatives encountered depending on age and setting.

Symptoms include localized bone pain, warmth, swelling, and fever. In children, irritability and refusal to walk may be the presenting signs; in vertebral involvement, back pain and fever are common. Disability or abscess can occur if not treated.

Diagnosis relies on history, exam, and tests. Blood tests may show elevated CRP and ESR; imaging starts with X-rays but MRI is most informative early. Bone biopsy or blood cultures help identify the organism and guide antibiotics.

Treatment combines antibiotics and sometimes surgery. Intravenous antibiotics are started and later tailored to culture results, for several weeks. Debridement or drainage may be needed for necrotic bone or abscess. Management also includes addressing underlying conditions and preventing complications.

Prognosis improves with early treatment; delayed therapy increases risk of chronic infection, bone damage, and functional impairment. Prevention focuses on prompt infection control, vaccination where applicable, and careful wound care.