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Osteomyelitis

Osteomyelitis is infection of the bone and medulla bone well as non-pyogenic or pyogenic infections,For example mikrobacterium tuberculosa. It can remain localized or can spread through bone marrow involves the cortex, and periosteum. Ostemyelitis can be acute or chronicDEFINITION OSTEOMYELITIS

Basically, all types of organismsincluding viruses, parasites, fungi, and bacteria can cause osteomyelitis.Most often caused by certain pyogenic bacteria and mycrobacteriaETIOLOGY

1.Staphylococcus aureus(90%)2.Salmonella thyposa3.Streptococcus hemolitikus4.Pseudomonas aurenginosa5.Escherechia coli6.Clastridium perfringen7.Neisseria gonorhoeae

Mycrobacterium cause osteomyelitis

Diabetes mellitusPatients receiving hemodialysisPeople with bad immune systems Sickle cell diseaseIntravenous drug abuseAge (especially regarding baby and children)AlcoholismLong-term steroid useChronic joint diseaseTrauma (orthopedic surgery or open fracture)The use of prosthetic orthopedic

RISK FACTOROsteomyelitis can generally be classified based on the clinical course, osteomyelitis acute. subacute. and chronic. It depends on the intensity of the infection and symptoms related.CLASSIFICATIONA. Clinical Symptoms Of Acute OsteomyelitisIN EARLY DISEASE,systemic symptoms such as febrile, anorexia, and malaise prominent, while the local symptoms such as swelling or cellulitis not appear.IN NEWBORNSinfants looked nervous, and irritable. Usually more common in infants with 'high risk' as premature, underweight babies history of difficult umbilical artery cathetersIN ADULTS,the most common place is on the predilection thorakolumbal vertebra. Can only attack patients with a history of problems in the urinary tract

CLINICAL SYMPTOMSB. Clinical Symptoms Of Subacute OsteomyelitisHaematogenous Subacute osteomyelitis usually found in children and adolescents. Clinical features that can be found is muscle atrophy, local pain, a little swelling, and can also be crippled sufferer. Feel pain in the area around the joint for a few weeks or months. The patient's body temperature is usually normal.

C. Clinical symptoms of choronic osteomyelitisLocalized bone pain, redness, and drainage around the affected area often arise. On physical examination findings sinus, fistula or cicatricial scar with tenderness, deformity, instability, and signs of the disorder vascularization, range of motion, and neurological status. May be found protruding sekuestrumCLINICAL SYMPTOMSRADIOGRAPHYIn osteomyelitis of the extremities, photo plain radiographs and bone scintigrafi is the primary screening tool. Radiographic evidence of osteomyelitis will not appear until approximately two weeks after the onset of infectionSCINTIGRAFI BONEFor imaging nuclir, Technetium Tc-99m methylene difosfonat is the main agent of choice. The sensitivity of this examination is limited to the first week and not at all specificMRI (MAGNETIC RESONANCE IMAGING)Magnetic resonance imaging (MRI) is helpful in detecting osteomyelitis. MRI is superior when compared to radiography, CT scans and bone scintigrafi MRI had a sensitivity of 90-100% in the detection of osteomyelitisDIAGNOSISULTRASONOGRAFI DAN CT (COMPUTED TOMOGRAPHIC) SCANUltrasonography and CT scan can help diagnose osteomyelitis. Ultrasound can show the changes as early as 1-2 days after onset of symptoms. Ultrasound can show abnormalities including soft tissue abscesses or accumulation of fluid (such as abscesses) and periosteal elevation. Ultrasound can also be used to guide the conduct of aspiration. However, ultrasound is not used to evaluate bone cortex.DIAGNOSISACUTE OSTEOMYELITISresting the affected limb (if necessary use a splint or traction) and immediately given antibiotics. Broad-spectrum antibiotics effective against gram-positive and gram-negative given directly pending the outcome of the bacteria culture. Antibiotics are given for 3-6 weeks to see the general state of the patient and erythrocyte sedimentation rateOSTEOMYELITIS SUBACUTEantibiotics in accordance with gram group, culture, and sensitivity must be initiated intravenously for 2-7 days, followed by oral antibiotics for 6 weeks

TREATMENTChronic Osteomyelitis1. AntibioticsChronic osteomyelitis can not be treated with antibiotics solely antibiotics aimed at:-Preventing the spread of infection in an otherwise healthy bones-Controlling exacerbations

2. Measures operative procedure performed when acute exacerbation phase has subsided after administration and adequate antibiotic treatment.

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