Bone Symposium '91 Held in Portland Oregon, on 17-20 July 1991.

摘要

The term osteomyelitis refers to an inflammation of the marrow (myelitis) of the bone (osteo). However, the diagnosis is generally made in reference to an infection involving the cortical and/or medullary portions of a bone. Based on etiologic and clinical considerations, bone infections have traditionally been classified as either hematogenous osteomyelitis or osteomyelitis secondary to contiguous focus of infection. Contiguous focus osteomyelitis has been further subdivided into osteomyelitis in patients who have relatively normal vascularity and patients with generalized vascular insufficiency. Osteomyelitis may be acute or chronic. The acute disease is characterized by a suppurative infection accompanied by edema, vascular congestion, and small vessel thrombosis. The vascular supply to the bone is compromised as the infection extends into the surrounding soft tissue. Large areas of dead bone (sequestra) may be formed when both the medullary and periosteal blood supplies are compromised. Viable colonies of bacteria may be harbored within the necrotic and ischemic tissues even after an intense host response, surgery, and or therapeutic antibiotics. Once the antibiotics are discontinued or the host response declines, the organisms may again proliferate and lead to a recurrence of the infection.