Introduction Introduction Osteomyelitis is characterized by progressive inflammatory destruction of bone, bone necrosis, and new bone formation. Often difficult to diagnose and treat, osteomyelitis poses a challenge to the primary care physician and the orthopedist. Even when appropriate antibiotic therapy is instituted promptly, osteomyelitis can cause serious morbidity.
Chronic cases are often refractory to aggressive treatment.
The etiology of and antibiotic therapy for osteomyelitis have evolved considerably over the past 2 decades. Although S. aureus is still a common cause of osteomyelitis, gram-negative organisms, such as Pseudomonas aeruginosa, are often seen, and an increasing number of infections are polymicrobial. In addition, coagulase-negative staphylococci, once considered contaminants, are now considered significant pathogens that require aggressive treatment. These changes in etiology and epidemiology, combined with improvements in the techniques for diagnosing and treating bone infections, indicate a need to reexamine traditional management of patients with osteomyelitis.