Osteomyelitis

Osteomyelitis is an uncommon but important infectious disease that affects individuals of all ages. A thorough history and physical examination are essential in the evaluation of osteomyelitis. In many cases, laboratory studies and cultures can assist in making the diagnosis. Additional evaluation with plain radiographs, nuclear medicine testing, CT, or MRI may be helpful in certain cases. Empirical antibiotics should be promptly started in all cases of suspected osteomyelitis after blood or bone cultures have been obtained. Persistent infections require surgical debridement because treatment failures often result from inadequate surgical therapy.Diabetics are particularly prone to pedal osteomyelitis and need aggressive therapy with antibiotics and local surgical care. Vertebral osteomyelitis is arare infection that typically affects the lumbar spine of older men and responds well to systemic antibiotics. Despite modern medical and surgical therapy, osteomyelitis may recur after long periods of inactivity. Nonetheless, most individuals with osteomyelitis have excellent long-term prognoses with prompt recognition and appropriate treatment.