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Osteomyelitis

Thuy Le, DO and Obiefuna Okoye, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • An acute or chronic bone infection with associated inflammation; can occur as a result of hematogenous seeding, contiguous spread of infection, or direct inoculation into intact bone...

DIAGNOSIS

HISTORY

  • Fever, chills, lethargy (particularly in children)

  • Pain, swelling, erythema in affected area

  • Hematogenous osteomyelitis

    • Elicit a history of conditions predisposing to bacteremia (diabe...

TREATMENT

GENERAL MEASURES

  • Adequate nutrition

  • Smoking cessation

  • Control diabetes

MEDICATION

  • Direct empiric therapy toward probable organism and tailor according to culture results.

  • Optimal antimicrobial con...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

Blood levels of antimicrobial agents, ESR, CRP, and repeat plain radiography as clinical course dictates 

PATIENT EDUCATION

Diabetic glycemic cont...

REFERENCES

1
Malhotra R, Chan CS, Nather A. Osteomyelitis in the diabetic foot. Diabet Foot Ankle.  2014;5. [View Abstract on OvidMedline]
2
Howard-Jones AR, Isaacs D. Systematic review of duration...

ADDITIONAL READING

  • Bhavan KP, Marschall J, Olsen MA, et al. The epidemiology of hematogenous vertebral osteomyelitis: a cohort study in a tertiary care hospital. BMC Infect Dis.  2010;10:158. [V...

CODES

ICD10

  • M86.9 Osteomyelitis, unspecified

  • M86.00 Acute hematogenous osteomyelitis, unspecified site

  • M86.10 Other acute osteomyelitis, unspecified site

  • M86.8X5 Other osteomyelitis, thigh

  • M86.50 Other chr...

CLINICAL PEARLS

  • Hematogenous osteomyelitis is usually monomicrobial. Osteomyelitis due to contiguous spread or direct inoculation is usually polymicrobial.

  • Pain associated with acute osteomyelitis typi...

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