Osteomyelitis
Etiology

1. most common organism is Staphylococcus aureus
2. Salmonella typhi in patients with sickle cell disease
3. In neonates and immunocompromised patients Gram-negative organisms (H. influenzae) are more common.
4. 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 )