Predisposing factors: vascular insufficiency disorders genitourinary infections respiratory infections IV drug use immunocompromising diseases history of blood-

stream infections Indwelling prosthetic devices Open wounds/ fractures Microorganisms gain entry by way of blood Microorganisms lodge into an area where circulation slows Microorganisms grow Increase pressure Ischemia Vascular compromise of the periosteum Infection through the bone cortex and marrow Cortical devascularization Debridement necrosis fever, night sweats, chills, restlessness, nausea and malaise constant bone pain, swelling, tenderness, warmth at the infection site, restricted movement of the affected part

Formation of new bone Involcrum

Separation of devitalized bone from living bone Continues to be an infected island Difficulty to reach by blood borne antibiotics Enlarged sequestrum

Sequestra

Chronic stage

drainage from sinus tracts

Development of sinus tract Turns to scar tissue

Sequestrum move out to the soft tissue revascularized Removal by the normal immune process Healing

Systemic signs may be diminished with constant bone pain, Swelling, tenderness, warmth at the infection site

Site for continued microorganism growth Remission and exacerbation Excessive vascular insufficiency Loss of organ function Amputation