References:
1. Urish KL, Cassat JE. Staphylococcus aureus Osteomyelitis: Bone, Bugs, and Surgery. Infect Immun. 2020 Jun 22;88(7):e00932-19. doi: 10.1128/IAI.00932-19. PMID: 32094258; PMCID: PMC7309607.
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Osteomyelitis
Outcomes 4
Often diagnosing the causative agent
is difficult, and antibiotic therapy requires
changing, this can affect the outcome for
patients.
Outcomes depend on several factos
Predisposing factors such as
diabetes, early diagnosis, location,
early intervention impact outcomes.
Long hospital stays, and surgical outcomes
factor in to patient outcomes.
If amputation is required this will
have a significant impact on patient
quality of life.
Surgical intervention is associated with
poor outcomes and recovery.
Psychosocial impacts vary greatly. Often
anxiety, depression and isolation are related
to lengthy hospital stays.
With early intervention, most patients make
a full recovery.
Psychosocial Outcomes
Cost of hospital admission during treatment
is significant.
Chronic Osteomyelitis has a more severe psychosocial
impact with multiple hospitalisations and surgeries.
Early detection is key in minimising costs associated with
treatment
Increased levels of depression and other co-morbidities
are associated with diagnosis of Chronic osteomyelitis [5]
Diagnosis 3
Aspiration of the affected area
for collection and analysis of tissue
is the gold standard for diagnosis.
Blood testing can help detect
osteomyelitis, however has low
specificity.
ESR and CPR rates are
useful in detection, however
they have low specificty.
Blood culture is can detect
pathogens if spread hematogenously
Diagnostic Imaging can
be utilised.
MRI is more effective
X-Ray imaging is
poor at early detection
Diagnosis is complex
often requires several
diagnostic procedures
Patient presentation plays a huge
role in diagnosis.
Fever, local pain and refusal
to use affected limb are all
common presentations.
Management 2
Management often requires extensive
hospital stays, exceeding 4 weeks.
Non-Surgical
IV antibiotic therapy.
Antibiotic prescription varies depending
on causative agent.
Surgical
Surgical treatment involves aspiration of
the affected bone.
Includes removal of dead tissue, purulent matter
and amputation.
Pathophysiology
Can be acute or chronic in nature
Causes destruction and necrosis
of the infected bone
https://ars-els-cdn-com.ezproxy.lib.rmit.edu.au/content/image/1-s2.0-S0140673604167275-gr1_lrg.jpg
Often aquired from a primary
infection elsewhere in the body
Spread directly from open wound
Hematogenous spread
Bacterial or fungal infection
Staphylococcus Aureus is the
most common causative agent (70%) 1
