Osteomyelitis in adults: A prospective study of 60 cases (original) (raw)
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OSTEOMYELITIS: FROM DIAGNOSIS TO TREATMENT (Atena Editora)
OSTEOMYELITIS: FROM DIAGNOSIS TO TREATMENT (Atena Editora), 2023
This study aimed to carry out a bibliographic review about Osteomyelitis, a bone inflammation caused by an infection. Since 1984, osteomyelitis has been known, which is a bone inflammation due to a constant infection process, which occurs when a pathogen has access to the bone through an exposed wound, or resulting from trauma or a post-surgical procedure. To make the diagnosis, when the individual presents signs and symptoms (fever, chills, abscesses, edema and local erythema), which can be localized or systemic. We identified it through alterations in an X-ray exam, also requiring complementary exams. This pathology has different classifications, but with a standard initial treatment, with the use of drugs and even surgical intervention in more severe cases. The highlight is given to the group most affected by the pathology, men, whites aged over 60 years are the most seriously affected. This way, it is necessary to give due importance to carrying out more research and forms of prevention for this pathology and its consequences.
The management of osteomyelitis in the adult
Bone infection Clinical management a b s t r a c t Background and purpose: Osteomyelitis (OM) is considered one of the most challenging medical conditions an orthopaedic surgeon has to face. Much debate is present concerning diagnosis and treatment, especially about differences between acute and chronic forms of the condition. The main aim of the present work is to show the key points where research should be implemented. Methods: Online database were searched to find evidence about the clinical management of osteomyelitis. Clinical randomized trials, case series, prospective cohort studies reporting on diagnosis and treatment of acute and chronic osteomyelitis were taken into consideration. Cadaveric studies, laboratory studies, case reports, review articles and metaanalyses were excluded. Furthermore, studies concerning implant related OM were excluded. Studies in English, Spanish and French were considered in this process of inclusion. The cohorts of all the included studies were composed of adult patients.
Acute and Chronic Osteomyelitis
Clinical Infectious Disease
NOWHERE has the influence of the antibiotics been more spectacular than in the reduction of the incidence of osteomyelitis. The ear, throat and skin infections of children which were once so commonly followed by hematogenous infection of bones are now prevented or minimized, and even when such an infection becomes established, it is rarely followed by complications. Furthermore, these drugs have permitted the use of previously impossible technics in the handling of those bone infections which still result so that surgical treatment is now much less time consuming, less dangerous, and much more satisfactory. It is customary to list three types of osteomyelitis: acute hematogenous infection; osteomyelitis by direct extension from adjacent infection; and infection of bone by direct contamination as in compound fractures. Actually it makes little practical difference by what route the infectious agent arrives at the bone except that the infections which are not blood borne tend to be less virulent and to remain better localized. Each case must be evaluated individually and the appropriate treatment chosen after all factors have been carefully weighed. It is of course true that compound injuries are apt to present a mixed bacteriology and also to include certain organisms, such as those of gas gangrene, which are rarely found otherwise. In 90 per cent of the hematogenous lesions the infection is due to hemolytic Staphylococcus aureus. Next most common are streptococcus and pneumococcus infections. The very small percentage of cases not included in these groups includes instances of osteomyelitis due to every known suppurative organism from typhoid and salmonella to brucella. In infants the relative incidence of streptococcic infection is higher. Needless to say, cultures are essential to the diagnosis and treatment of any case of osteomyelitis. ACUTE OSTEOMYELITIS Acute hematogenous osteomyelitis, although it may be seen at any age, is essentially a disease of childhood and adolescence. As stated above, it results often as a complication of a pre-existing infection such as a boil or an otitis media. Trauma is almost routinely mentioned as a predisposing factor, but its role is impossible to assess, and probably of minor importance. Symptoms.-Although it is obvious that at some stage in the evolution of the hematogenous lesion there must be a true bacteremia, this is us-From the
PLOS ONE, 2015
Osteomyelitis is a heterogeneous infection with regard to etiology and treatment, and currently no single management protocol exists. Management of the condition is typically an interdisciplinary approach between orthopedics and infectious disease; however, the orthopedist is often the person who manages treatment. The aim of the study was to determine differences in the outcome of osteomyelitis according to its treating specialty and to identify factors associated with the recurrence of the disease. An ambispective cohort study of 129 patients with osteomyelitis was conducted and the proportions for qualitative variables and central tendency and dispersion measures for quantitative variables were calculated; the latter were tested for normality using the Shapiro-Wilk test. A bivariate analysis was conducted with measures of association based on the chi square test and crude relative risk. A logistic regression model was applied and statistical significance was set at p < 0.05, including the model of relevant clinical variables that fit the Hosmer-Lemeshow test. We found that 70% of patients were treated either by orthopedics or infectious disease. Patients who were treated by an orthopedist alone presented a greater risk of relapse or reinfection (RR = 4.6; 95% CI 2.3;8.9). Risk factors of osteomyelitis recurrence as determined in the regression model included the following: age of 57 years or older (RR = 1.3; 95% 0.3;5.2), long bones (RR = 1.9; 95% CI 0.5;7.1), fracture (RR = 5.0; 95% CI 0.4;51.4), monotherapy (RR = 3.0; 95% CI 0.6;14.5), receiving less than 4 weeks of antibiotics (RR = 1.5; 95% CI 0.2;10.1), inadequate treatment (RR = 3.1; 95% CI 0.4;20.1), and receiving orthopedics treatment (RR = 5.5; 95% CI 1.6;18.2). Most patients evaluated jointly by orthopedics and infectious disease received adequate treatment for osteomyelitis and had fewer relapses.
Pathogenetic features of chronic osteomyelitis treatment
Genij Ortopedii, 2021
Over the past decades, there has been a steady increase in the incidence of osteomyelitis. It is associated with an increased use of implants in traumatology and orthopedics. The social aspects of osteomyelitis are, on the one hand, significant financial costs for the healthcare system, and on the other hand, high recurrence and re-infection in the treatment of joint pathology associated with long-term loss of work ability and a high risk of patient’s disability. Purpose To conduct a search and analysis of publications in Russian and English, devoted to the problem of osteomyelitis and periprosthetic infection, on the basis of which to summarize the main current notions about the etiology, pathogenesis, diagnosis and treatment of osteomyelitis. Materials and methods The search was carried out in the Pubmed and CyberLeninka databases of literature sources over the past 10 years. The data were analyzed and compared with the materials from earlier publications. Only publications from p...
Diagnosis and Treatment Modalities for Osteomyelitis
Cureus, 2022
Osteomyelitis is an infection-related inflammatory disease of the bones. Imaging and laboratory results are typically used to support a clinical diagnosis of osteomyelitis. Microbial cultures and bone biopsies provide conclusive diagnoses. The first imaging procedure that needs to be done is radiography, but its sensitivity is low in the early stages of the disease. The sensitivity of magnetic resonance imaging, both with and without contrast material, is higher for detecting areas of bone necrosis in advanced stages. Patients can be categorised for surgical treatment using a staging system based on major and minor risk factors. The main course of treatment should be antibiotics, which should be chosen depending on the findings of the culture and the characteristics of each patient. Bony debridement surgery is frequently required, and in high-risk patients or those with severe illness, additional surgical intervention can be necessary. Better outcomes are being attained in the treatment of this illness thanks to advancements in surgical treatment, antibiotic therapy, and the current resources for precise diagnosis and tailored responses to each kind of osteomyelitis. The classification systems that are most frequently employed, as well as the general epidemiological ideas, are presented together with the discussion of acute and chronic osteomyelitis. The key recommendations for diagnosing infections clinically, in the laboratory, and through imaging are covered, along with the recommendations for surgical and antibiotic procedures, and the function of hyperbaric oxygen as adjuvant therapy. We evaluate the osteomyelitis-related articles, summarise the most recent developments in diagnostic procedures and therapeutic regimens, evaluate the benefits and drawbacks of various diagnostic modalities and therapeutic approaches, and suggest areas of focus to help current diagnostic and therapeutic approaches.
Recommendations for the treatment of osteomyelitis
The Brazilian Journal of Infectious Diseases, 2014
Keywords: Osteomyelitis Bone and joint infection Soft tissue infection Infectious diseases a b s t r a c t With the advances in surgical treatment, antibiotic therapy and the current resources for accurate diagnosis and differentiated approaches to each type of osteomyelitis, better results are being obtained in the treatment of this disease. After a careful literature review carried out by a multiprofessional team, some conclusions were made in order to guide medical approach to different types of osteomyelitis, aiming to obtain better clinical outcomes and reducing the social costs of this disease. Acute and chronic osteomyelitis are discussed, with presentation of the general epidemiological concepts and the commonly used classification systems. The main guidelines for the clinical, laboratory and imaging diagnosis of infections are discussed, as well as the guidelines for surgical and antimicrobial treatments, and the role of hyperbaric oxygen as adjuvant therapy. (P.R. Oliveira). ♦ The members of the Diretrizes Panamericanas para el Tratamiento de las Osteomielitis e Infecciones de Tejidos Blandos Group are listed in Appendix A.
Causes and Management of Osteomyelitis
2019
Introduction: Depending on the infection's particular features (etiology, pathogenesis, extent of bone involvement, and duration) and the patient (infant, child, adult, or immunocompromised) a variety of challenges is present of osteomyelitis in long bones. Tremendous progress was made in the four past decades in the treatment of osteomyelitis as the many factors that account for the occurrence and persistence of infection have been found and a variety of antimicrobials with other spectrums of activity against microbes have been developed.