Osteomyelitis
Osteomyelitis
Etiology
- most common organism is Staphylococcus aureus
- Salmonella typhi in patients with sickle cell disease
- In neonates and immunocompromised patients Gram-negative organisms (H. influenzae) are more common.
- In IV drug abusers – E. Coli, Pseudomonas, Klebsiella
Clinical Presentation
- Most commonly localized extremity pain ± fever, erythema or swelling, 1 to 2 wks after respiratory infection or infection at another non-bony site
- common sites: long bones (children), vertebrae (adults)
Investigations
- bone biopsy, blood culture, aspirate cultures, ESR, CRP, CBC (leukocytosis)
- x-ray, bone scan (increased uptake within 24-48 h after onset in majority of patients)
- MRI most sensitive/specific (use for diabetic foot ulcer or vertebral involvement )