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Harrison's Principles of Internal Medicine, 18e
| Part 8. Infectious Diseases > Section 2. Clinical Syndromes. Community-Acquired Infections > |
Chapter 126. Osteomyelitis
Sections: Osteomyelitis: Introduction, Further Readings.
Topics Discussed: bone and joint infections; osteomyelitis.
Excerpt:"Osteomyelitis, an infection of bone that leads to tissue destruction and often to debility, can be caused by a wide variety of bacteria (including mycobacteria) and fungi and may be associated with viral infections. Its management must be individualized and depends on numerous factors, including the causative organism, the specific bone involved, vascular supply, nerve function, foreign bodies, recent injury, the physiologic status of the host, and associated comorbidities. The spectrum of the disease can range from extensive (e.g., tibial and vertebral osteomyelitis) to localized (e.g., bone invasion associated with a tooth abscess). Two major classification systems for osteomyelitis are used in making decisions about medical therapy and surgery. Lee and Waldvogel categorized cases as acute or chronic, hematogenous or contiguous, and with or without vascular compromise. The Cierny and Mader classification system for long-bone osteomyelitis encompasses the location and extent of the infection as well as a number of other factors.The foremost bacterial cause of osteomyelitis is Staphylococcus aureus. Gram-negative organisms such as Pseudomonas aeruginosa and Escherichia coli, coagulase-negative staphylococci, enterococci, and propionibacteria..."
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