Osteomyelitis: Bacterial Overview

Osteomyelitis: Bacterial

• Acute Hematogenous Osteomyelitis:

  • Caused by infections or trauma that spread through the bloodstream
  • Primarily affects children
  • Common sites: long bones (e.g., femurs, tibias) and vertebrae
  • Pathological features include: subperiosteal abscesses, bone necrosis, and sinus formation
  • Spread occurs through direct extension, or through the blood stream in the case of hematogenous infection

• Non-Hematogenous Osteomyelitis:

  • Infection originating from an adjacent site, such as a fracture or soft tissue injury
  • Can lead to the direct spread of infection to the bone
  • Most commonly involves infection of the skull bones
  • Pathological features, such as bone necrosis
  • Infection can spread directly or via the blood stream

• Tuberculosis Osteomyelitis (Specific):

  • Infection of the bone due to Mycobacterium tuberculosis
  • Primarily affects the vertebra column, causing
  • Pathological features include: vertebral destruction, caseous material, kyphosis
  • Cold abscess formation is common
  • Infection can spread through the blood stream or through direct contact

• Chronic Osteomyelitis:

  • Long-lasting bone infections
  • Often associated with granuloma formation, abscess formation or cold abscess formation

• Chronic Osteomyelitis (Sclerosing):

  • Characterized by bone sclerosis (hardening)
  • Pathological features include: bone thickening, and abscess formation
  • Commonly found in long bones, and can spread to nearby joints

• Non-Specific Osteomyelitis (Brodie Abscess):

  • Localized area of infection in the bone
  • Frequently caused by Staphylococcus aureus
  • May be preceded by an acute infection

Specific Locations

• Long bones: Infection can lead to subperiosteal abscess spread to surrounding joints
• Jaw: Extensive new bone formation, followed by surrounding sclerotic bone

Complications

• Pathological fractures: Bone weakening due to infection or inflammation
• Tuberculosis arthritis: Infection spreading to the joints
• Amyloidosis: A secondary complication from chronic inflammatory processes,

Additional Notes

• Fracture and skull bones: Infection can spread to the tissues surrounding the fracture, including to the bone itself.

• Site of infection: The location where infection initially occurred is relevant to the specific type and spread of osteomyelitis.

• Distinction between acute and chronic: Acute osteomyelitis is a short-term infection; whereas chronic is more ongoing.