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Osteomyelitis

Dragomir Dragomirov, Meriyan Radeva, Natalia Stomatova, Rostislav Manev

Abstract

Introduction: Osteomyelitis is an infection and inflammation of the bone or the bone marrow, caused by an infecting organism. Although bone is normally resistant to bacterial colonization, events such as trauma, surgery, the presence of foreign bodies, or the placement of prostheses may disrupt bony integrity and lead to the onset of bone infection. Osteomyelitis can also result from hematogenous spread after bacteremia. Other risk factors are conditions that impair the immune system; circulatory problems as poorly controlled diabetes, peripheral arterial disease, often related to smoking, sickle cell disease; problems requiring intravenous lines or catheters as dialysis machine tubing, urinary catheters, long-term intravenous tubing; illicit drugs.  Early and specific treatment is important in osteomyelitis, and identification of the microorganisms causing the disease is essential for antibiotic therapy. Staphylococcus aureus is the most frequently isolated microorganism in these patients. Methicillin-resistant S. aureus (MRSA) is usually considered a nosocomial pathogen, but it is increasingly acquired in the community

Materials and Methods: We present a case that begins as acute osteomyelitis but evolves into chronic condition. The disease occurred after inflammation caused by fracture of the femur.  Microbiological and pathological examination is necessary to confirm the diagnosis of osteomyelitis and to proceed to targeted and long-lasting antibiotic therapy, which usually includes combination of antimicrobial agents.

Results: If left untreated, the infection can become chronic and cause loss of blood supply to the affected bone. When this happens, it can lead to the eventual necrosis of the bone tissue. It requires surgical removal.

Conclusion: This case report offers a basic review of the classification, etiology, epidemiology, pathogenesis, and treatment of osteomyelitis.


Keywords

osteomyelitis, methicillin-resistant S. aureus, S. aureus


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