OSTEOMYELITIS Introduction Osteomyelitis is a bone infection usually caused by bacteria, including mycobacteria, but is sometimes caused by fungi.

When a bone becomes infected, the soft, inner part (bone marrow) often swells. As the swollen tissue presses against the rigid outer wall of the bone, the blood vessels in the bone marrow may become compressed that reduces or cuts off the blood supply to the bone. Without an adequate blood supply, parts of the bone may die. These areas of dead bone are difficult to cure of infection because it is difficult for the body's natural infection-fighting cells and antibiotics to reach them. The infection can also spread outward from the bone to form collections of pus (abscesses) in adjacent soft tissues, such as the muscle. When organisms that cause osteomyelitis spread through the bloodstream, infection usually occurs in the ends of leg and arm bones in children and in the spine (vertebrae) in adults, particularly in older people. Infections of the vertebrae are referred to as vertebral osteomyelitis. People who undergo kidney dialysis and those who inject drugs using non-sterile needles are particularly susceptible to vertebral osteomyelitis. Bacteria or fungal spores may infect the bone directly through open fractures, during bone surgery, or from contaminated objects that pierce the bone. Staphylococcus aureus is the bacteria most commonly responsible. Mycobacterium tuberculosis (the main cause of tuberculosis) can infect the vertebrae to cause osteomyelitis. Osteomyelitis occurs most commonly in young children and in older people, but all age groups are at risk. Osteomyelitis is also more likely to occur in people with serious medical conditions. About 1 in 5000 children develop osteomyelitis in the US each year. About 15 percent of those who suffer a puncture wound to the foot develop osteomyelitis. References: http://www.merckmanuals.com/home/sec05/ch065/ch065b.html http://www.freemd.com/osteomyelitis/incidence.htm