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Osteomyelitis (Visit this link)
Author: Ahmad Bo-Eisa, MD, Chairman, Program Director, Department of Orthopedic Surgery, King Fahad Hospital, Saudi Arabia Coauthor(s): Sadek Al-Omran, MD, Consultant Of Pediatrics and Pediatric Nephrologist, Departments of Pediatrics and Pediatric Nephrology, Maternity and Children's Hospital-Al-Ahsa, Saudi Arabia; Abbas Al-Abbad, MD, Pediatric Nephrology Fellowship Program Director, Section of Pediatric Nephrology, Department of Pediatrics, Pediatrics, King Faisal Specialist Hospital and Research Center Riyadh, Saudi Arabia Osteomyelitis is a difficult-to-treat infection of bone and bone marrow. It is progressive and results in inflammatory destruction of the bone, bone necrosis, and new bone formation. Bacterial osteomyelitis causes substantial morbidity worldwide, despite continued progress toward understanding its pathophysiology and optimal management. The approach to osteomyelitis depends upon the route by which bacteria gained access to bone, bacterial virulence, local and systemic host immune factors, and patient age. While imaging studies and nonspecific blood tests may suggest the diagnosis, an invasive technique is generally required to identify the causative pathogens. Antibacterial regimen selection has been largely guided by knowledge of the relative activities and pharmacokinetics of individual drugs, supported by data from animal models. Definitive therapy often requires a combined medical and surgical approach. Newer microvascular and distraction osteogenesis techniques and the use of laser Doppler allow more complete surgical resection of infected material while maintaining function. Despite recent advances, aggressive medical and surgical therapy fails in many patients with osteomyelitis. More accurate diagnostic methods, better ways to assess and monitor the effectiveness of therapy, and novel approaches to eradicate sequestered bacteria are needed.
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Added: Thu Apr 13 2006
Last Modified: Sat Nov 03 2007
