Osteomyelitis is caused by bacteria, fungi or mycobacteria inflammation and destruction of the bone. Typical symptoms include localized bone pain and pressure pain at the acute form, in conjunction with, in the chronic form without general symptoms. The diagnosis is made by means of imaging and cultures, the therapy is carried out surgically and antibiotic in a proportion of cases.

Osteomyelitis is caused by bacteria, fungi or mycobacteria inflammation and destruction of the bone. Typical symptoms include localized bone pain and pressure pain at the acute form, in conjunction with, in the chronic form without general symptoms. The diagnosis is made by means of imaging and cultures, the therapy is carried out surgically and antibiotic in a proportion of cases. Etiology osteomyelitis caused by: infected neighboring tissue by continuity or an infected joint prosthesis hematogenous spread of pathogenic micro-organisms (hematogenous osteomyelitis) open wounds (because of contaminated open fractures or bone surgery) trauma, ischemia and foreign bodies predispose to this infection, it can also arise under deep pressure ulcers , About 80% arise from the environment or through open wounds, often with polymicrobial colonization. At ? 50% of patients Staphylococcus aureus (incl. Methicillin-sensitive and methicillin-resistant strains) is present, more frequent pathogens are streptococci, gram-negative enteric microorganisms and anaerobes. Osteomyelitis by propagating from the environment often affects the feet (eg in diabetics or patients with AVK.); it is still often at locations where a bone was injured traumatically or surgically, in places that are damaged as a result of radiation therapy, and bone under pressure ulcers, eg. B. hip and sacrum. A sinus, gum, or tooth infection may spread to the skull. Osteomyelitis caused hematogenous usually caused by a single pathogen. In children, these are v. a. Gram-positive bacteria that infect the metaphysis of the tibia, femur or the humerus in the first place. In adults, the vertebrae are most commonly affected. Old age, disability, hemodialysis, sickle cell anemia and i.v. Drug abuse are the main risk factors. Common infectious agents are: (is methicillin-resistant S. aureus [MRSA] common) S. aureus and enteric gram-negative bacteria At intravenous drug users: In elderly, debilitated or hemodialysis requiring adult S. aureus, Pseudomonas aeruginosa and Serratia sp In patients with sickle cell disease, liver disease or immunodeficiency: Salmonella sp fungi and mycobacteria may have a hematogenous osteomyelitis resulting v. a. cause in immunocompromised patients, as well as in areas with endemic Histoplasmose-, Blastomykose- or Kokzidioidomykoseinfektion. Again, the vertebrae are affected. Pathophysiology osteomyelitis often creates a seal in local blood vessels, characterized arise osteonecrosis and a local spread of infection. This can spread through the cortical bone under the periosteum, there may be for subcutaneous abscess with spontaneous drainage through the skin. In osteomyelitis of the vertebrae, a epidural abscess may develop. If the treatment of acute osteomyelitis is only partially successful, a low active chronic form can result. Symptoms and discomfort in patients with acute osteomyelitis of peripheral bones are commonly found weight loss, fatigue, fever and localized hyperthermia, swelling, erythema, and tenderness. Osteomyelitis of the vertebral body causing localized back pain and pain associated with massive paravertebral muscle spasms, do not respond to conservative treatment trials. In advanced disease, it can lead to a compression of the spinal cord or nerve roots, with radicular pain and weakness or numbness of the extremities. Fever is often not available. Chronic osteomyelitis leads for months to many years to intermittent bone pain, tenderness and draining sinuses. Diagnostic erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) X-rays, MRI or bone scintigraphy culture of bone and / or abscess Acute osteomyelitis in patients with localized peripheral bone pain, fever and malaise, but also with localized refractory spinal pain, particularly in patients with recent onset of risk factors for BateriƤmie to accept. Chronic osteomyelitis can be considered in patients with persistent localized bone pain, v. a. if they have risk factors. In cases of suspected osteomyelitis blood count, ESR and CRP should be determined, as well as radiographs should be provided by the affected bone. Leukocytosis, and an assessment of ESR and CRP support the diagnosis. However, ESR and CRP may be elevated in inflammatory diseases such as RA or normal at a indolent caused by pathogens infection. Therefore, the findings of these tests must be seen in the context of the physical examination and the results of imaging. The X-rays are abnormal after about 2-4 weeks, you can see an increase in the periosteum, bone destruction, soft tissue swelling, loss of height in the vertebral bodies, a narrowing of the adjacent mitinfizierten disc space and a destruction of the cover plates above and below the affected disc space. Osteomyelitis Photo courtesy of Byron (Pete) Benson, DDS, MS. Texas A & M University Baylor College of Dentistry. var model = {thumbnailUrl: ‘/-/media/manual/professional/images/osteomyelitis-pano-murchison-dental-emergencies-pv-high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/ – / media /manual/professional/images/osteomyelitis-pano-murchison-dental-emergencies-pv-high_de.jpg?la=de&thn=0 ‘, title:’ osteomyelitis ‘description:’ u003Ca id = “v37892878 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eDas radiograph shows osteomyelitis with an apparent sequestration in the left rear quadrant of. u003c / p u003e u003c / div u003e ‘credits’ photo courtesy of Byron (Pete) Benson

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