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{{Osteomyelitis}}
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==Overview==
The etiology of osteomyelitis include a wide range of microbes, organized based on prevalence in patients of different age groups.
 
==Causes==
Etiolgic agents of osteomyelitis can be classified in several ways.
 
===Etiologies based on age group===
 
{| class="wikitable"
|-
| '''Age group'''
| '''Most common organisms'''
|-
| Newborns (younger than 4 mo)
| ''[[Staphylococcus aureus|S. aureus]]'', ''[[Enterobacter]]'' species, and [[Group A streptococcal infection|group A]] and [[Group B streptococcal infection|B]] ''Streptococcus'' species
|-
| Children (aged 4 mo to 4 y)
| ''[[Staphylococcus aureus|S. aureus]]'', [[Group A streptococcal infection|group A]] ''Streptococcus'' species, ''[[Haemophilus influenzae]]'', and ''[[Enterobacter]]'' species
|-
| Children, adolescents (aged 4 y to adult)
| ''[[Staphylococcus aureus|S. aureus]]'' (80%), [[Group A streptococcal infection|group A]] ''Streptococcus'' species, ''[[Haemophilus influenzae|H. influenzae]]'', and ''[[Enterobacter]]'' species
|-
| Adult
| ''[[Staphylococcus aureus|S. aureus]]'' and occasionally ''[[Enterobacter]]'' or ''[[Streptococcus]]'' species
|}
 
 
=== Microbiology based on prevalence ===
 
 
<br><br><br><br>
 
 
{{Family tree/start}}
{{Family tree | | | | | | | | | A01 | | | | | | | | |A01= Microbiology of osteomyelitis}}
{{Family tree | | | | | | | | | |!| | | | | | |}}
{{Family tree | | | | |,|-|-|-|-|+|-|-|-|-|.| |}}
{{Family tree | | | | C01 | | | C02 | | | C03 | |C01= Common causes<br> ≥ 50% cases| C02= Occasional causes<br> 25%-49% cases| C03=Rare causes<br> <5% cases }}
{{Family tree | | | | |!| | | | |!| | | | |!| | |}}
{{Family tree |boxstyle=text-align: left; | | | D01 | | | | D02 | | | D03 | |D01= •[[Staphylococcus aureus]]<br>•[[Coagulase-negative staphylococci]]|D02=•[[ Streptococci]]<br>•[[Enterococci]]<br>•[[Pseudomonas]] spp<br>•[[Enterobacter]] spp<br>•[[Proteus]] spp<br>•[[Escherichia coli]]<br>•[[Serratia]] spp<br>•[[Anaerobes]] (Finegoldia spp, Clostridium spp, Bacteroides fragilis group)<br>•[[Mycobacterium tuberculosis]]|D03=•[[Mycobacterium avium-intracellulare]] complex<br>•Rapidly growing mycobacteria<br>•Dimorphic fungi ([[blastomycosis]], •[[coccidioidomycosis]], •[[sporotrichosis]])<br>•[[Candida]] spp<br>•[[Cryptococcus]]<br>•[[Aspergillus]] spp<br>•[[Mycoplasma]] spp<br>•[[Tropheryma whipplei]]<br>•[[Brucella]] spp<br>•[[Salmonella]] spp<br>•[[Actinomyces]]}}
{{Family tree/end}}
 
===Common Causes===
 
* [[Staphylococcus aureus]]
 
* [[Streptococcus pyogenes]]
 
* [[Haemophilus influenzae]]
 
*[[Enterobacter]]
 
* [[Escherichia coli]]
 
* [[Pseudomonas]]
 
* [[Streptococcus pneumoniae]]
 
* [[Mycobacterium tuberculosis]]
 
* [[Cellulitis]]
 
* [[Septic arthritis]]
 
* [[Fracture]]
 
===Causes by Organ System===
 
{|style="width:80%; height:100px" border="1"
| style="width:25%" bgcolor="lightsteelblue" ; border="1" | '''Cardiovascular'''
| style="width:75%" bgcolor="beige" ; border="1" | [[Arterial insufficiency ulcer]], [[Polyarteritis nodosa]], [[Thrombophlebitis]], [[Rheumatic fever]]
|-
|- bgcolor="lightsteelblue"
| '''Chemical / poisoning'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Dermatologic'''
| bgcolor="beige" | [[Cellulitis]], [[Marjolin's ulcer]], Fanconi like syndrome
|-
|- bgcolor="lightsteelblue"
| '''Drug Side Effect'''
| bgcolor="beige" | [[Daptomycin]], [[Flucloxacillin]], [[Pergolide]], [[Pramipexole]]
|-
|- bgcolor="lightsteelblue"
| '''Ear Nose Throat'''
| bgcolor="beige" | [[Otitis]]
|-
|- bgcolor="lightsteelblue"
| '''Endocrine'''
| bgcolor="beige" |  [[Diabetic myonecrosis]]
|-
|- bgcolor="lightsteelblue"
| '''Environmental'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Gastroenterologic'''
| bgcolor="beige" |  [[Gaucher disease]]
|-
|- bgcolor="lightsteelblue"
| '''Genetic'''
| bgcolor="beige" |  [[Congenital insensitivity to pain with anhidrosis]], [[Gaucher disease]], [[Infantile cortical hyperostosis]], [[Pycnodysostosis]], Thick skull syndrome
|-
|- bgcolor="lightsteelblue"
| '''Hematologic'''
| bgcolor="beige" | [[Acute lymphoblastic leukemia]], [[Acute myelocytic leukemia]], [[Deep vein thrombosis]], [[Multiple myeloma]], [[Sickle cell disease]]
|-
|- bgcolor="lightsteelblue"
| '''Iatrogenic'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Infectious Disease'''
| bgcolor="beige" | 
<u>'''Bacteria'''</u>: [[Arcanobacterium]], [[Bacteremia]], [[Bacteroides]], [[Brucellosis]], [[Campylobacterium sputorum]], [[Cat scratch disease]],[[Congenital syphilis]], [[Enterobacter]], [[Escherichia coli]], [[Group A streptococcal infection]], [[HACEK organism]],[[Haemophilus influenzae]], [[Klebsiella]], [[Melioidosis]], [[Mycobacterium boenickei]], [[Mycobacterium brisbanense]],[[Mycobacterium fortuitum]], [[Mycobacterium goodii]], [[Mycobacterium haemophilum]], [[Mycobacterium houstonense]],[[Mycobacterium lentiflavum]], [[Mycobacterium neworleansense]], [[Mycobacterium ulcerans]], [[Mycobacterium wolinskyi]],[[Neisseria gonorrhoeae]], [[Pasteurella multocida]], [[Pseudomonas]], [[Salmonellosis]], [[Sepsis]], [[Serratia]],[[Staphylococcus aureus]], [[Staphylococcus epidermidis]], [[Staphylococcus lugdunensis]], [[Streptococcus pneumoniae]],[[Streptococcus pyogenes]], [[Trench fever]], [[Treponema pallidum]], [[Yaws]],[[Mycobacterium tuberculosis]], [[Actinomycosis]],[[Gas gangrene]]
 
<u>'''Fungi'''</u>: [[Apophysomyces]], [[Candida albicans]], [[Coccidioidomycosis]], [[Sporotrichosis]]
|-
|- bgcolor="lightsteelblue"
| '''Musculoskeletal / Ortho'''
| bgcolor="beige" | [[Albers-Schonberg disease]], [[Avascular necrosis]], [[Brodie abscess]], [[Ewing sarcoma]], [[Fracture]]
[[Garre's sclerosing osteomyelitis]], [[Osteosarcoma]], [[Plantar fasciitis]], [[SAPHO syndrome]], [[Septic arthritis]], [[Infantile cortical hyperostosis]], Thick skull syndrome, [[Diabetic myonecrosis]], [[Multiple myeloma]]
|- bgcolor="lightsteelblue"
| '''Neurologic'''
| bgcolor="beige" |[[Neuroblastoma]], [[Neuropathic joint disease]]
|-
|- bgcolor="lightsteelblue"
| '''Nutritional / Metabolic'''
| bgcolor="beige" | [[Gout]], [[Pseudogout]], [[Scurvy]], [[Gaucher disease]]
   
|-
|- bgcolor="lightsteelblue"
| '''Obstetric/Gynecologic'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Oncologic'''
| bgcolor="beige" |[[Cementoblastoma]], [[Primary neuroectodermal tumors]], [[Marjolin's ulcer]], [[Acute lymphoblastic leukemia]], [[Acute myelocytic leukemia]], [[Multiple myeloma]], [[Ewing sarcoma]], [[Osteosarcoma]], [[Neuroblastoma]], Fanconi like syndrome
|-
|- bgcolor="lightsteelblue"
| '''Opthalmologic'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Overdose / Toxicity'''
| bgcolor="beige" | [[Radium]]
 
|-
|- bgcolor="lightsteelblue"
| '''Psychiatric'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Pulmonary'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Renal / Electrolyte'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Rheum / Immune / Allergy'''
| bgcolor="beige" | Fanconi like syndrome, [[Juvenile rheumatoid arthritis]], [[Rheumatic fever]], [[Serum sickness]], [[Synovial osteochondromatosis]], [[Transient synovitis]]
|-
|- bgcolor="lightsteelblue"
| '''Sexual'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Trauma'''
| bgcolor="beige" | [[Cephalhematoma]], [[Nursemaid's elbow]], [[Physical abuse]]
|-
|- bgcolor="lightsteelblue"
| '''Urologic'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Dental'''
| bgcolor="beige" | No underlying causes
|-
|- bgcolor="lightsteelblue"
| '''Miscellaneous'''
| bgcolor="beige" | [[Amyloidosis]], [[Animal bite]], [[Bedsore]], [[Eagle syndrome]], [[Ingrown nail]]
|-
|}
 
===Causes in Alphabetical Order===
{{Columns-list|3|
*[[Acremonium]]
*[[Actinomycosis]]
*[[Acute lymphoblastic leukemia]]
*[[Acute myelocytic leukemia]]
*[[Albers-Schonberg disease]]
*[[Amyloidosis]]
*[[Animal bite]]
*[[Apophysomyces]]
*[[Arcanobacterium]]
*[[Arterial insufficiency ulcer]]
*[[Avascular necrosis]]
*[[Bacteremia]]
*[[Bacteroides]]
*[[Bedsore]]
*[[Brodie abscess]]
*[[Brucellosis]]
*[[Campylobacterium sputorum]]
*[[Candida albicans]]
*[[Cat scratch disease]]
*[[Cellulitis]]
*[[Cementoblastoma]]
*[[Cephalhematoma]]
*[[Chronic granulomatous disease]]
*[[Coccidioidomycosis]]
*[[Congenital insensitivity to pain with anhidrosis]]
*[[Congenital syphilis]]
*[[Daptomycin]]
*[[Deep vein thrombosis]]
*[[Diabetic myonecrosis]]
*[[Eagle syndrome]]
*[[Enterobacter]]
*[[Escherichia coli]]
*[[Ewing sarcoma]]
*Fanconi like syndrome
*[[Flucloxacillin]]
*[[Fracture]]
*[[Garre's sclerosing osteomyelitis]]
*[[Gas gangrene]]
*[[Gaucher disease]]
*[[Gout]]
*[[Group A streptococcal infection]]
*[[HACEK organism]]
*[[Haemophilus influenzae]]
*[[Infantile cortical hyperostosis]]
*[[Ingrown nail]]
*[[Juvenile rheumatoid arthritis]]
*[[Klebsiella]]
*[[Marjolin's ulcer]]
*[[Melioidosis]]
*[[Multiple myeloma]]
*[[Mycobacterium boenickei]]
*[[Mycobacterium brisbanense]]
*[[Mycobacterium fortuitum]]
*[[Mycobacterium goodii]]
*[[Mycobacterium haemophilum]]
*[[Mycobacterium houstonense]]
*[[Mycobacterium lentiflavum]]
*[[Mycobacterium neworleansense]]
*[[Mycobacterium tuberculosis]]
*[[Mycobacterium ulcerans]]
*[[Mycobacterium wolinskyi]]
*[[Neisseria gonorrhoeae]]
*[[Neuroblastoma]]
*[[Neuropathic joint disease]]
*[[Nursemaid's elbow]]
*[[Osteosarcoma]]
*[[Otitis externa]]
*[[Pasteurella multocida]]
*[[Pergolide]]
*[[Physical abuse]]
*[[Plantar fasciitis]]
*[[Polyarteritis nodosa]]
*[[Primary neuroectodermal tumors]]
*[[Pseudogout]]
*[[Pseudomonas]]
*[[Pycnodysostosis]]
*[[Radium]]
*[[Rheumatic fever]]
*[[Salmonellosis]]
*[[SAPHO syndrome]]
*[[Scurvy]]
*[[Sepsis]]
*[[Septic arthritis]]
*[[Serratia]]
*[[Serum sickness]]
*[[Sickle-cell disease]]
*[[Sporotrichosis]]
*[[Staphylococcus aureus]]
*[[Staphylococcus epidermidis]]
*[[Staphylococcus lugdunensis]]
*[[Streptococcus pneumoniae]]
*[[Streptococcus pyogenes]]
*[[Synovial osteochondromatosis]]
*Thick skull syndrome
*[[Thrombophlebitis]]
*[[Transient synovitis]]
*[[Trench fever]]
*[[Treponema pallidum]]
*[[Yaws]]
}}


==References==
==References==


{{Reflist|2}}
{{Reflist|2}}
[[Category:Needs content]]
{{WH}}
{{WS}}
 
[[Category:Needs overview]]
[[Category:Orthopedics]]
[[Category:Orthopedics]]
[[Category:Bacterial diseases]]
[[Category:Bacterial diseases]]
[[Category:Skeletal disorders]]
[[Category:Skeletal disorders]]
[[Category:Disease]]
[[Category:Emergency mdicine]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Infectious disease]]
{{WH}}
{{WS}}

Latest revision as of 23:27, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]

Overview

The etiology of osteomyelitis include a wide range of microbes, organized based on prevalence in patients of different age groups.

Causes

Etiolgic agents of osteomyelitis can be classified in several ways.

Etiologies based on age group

Age group Most common organisms
Newborns (younger than 4 mo) S. aureus, Enterobacter species, and group A and B Streptococcus species
Children (aged 4 mo to 4 y) S. aureus, group A Streptococcus species, Haemophilus influenzae, and Enterobacter species
Children, adolescents (aged 4 y to adult) S. aureus (80%), group A Streptococcus species, H. influenzae, and Enterobacter species
Adult S. aureus and occasionally Enterobacter or Streptococcus species


Microbiology based on prevalence






 
 
 
 
 
 
 
 
Microbiology of osteomyelitis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Common causes
≥ 50% cases
 
 
Occasional causes
25%-49% cases
 
 
Rare causes
<5% cases
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
•Staphylococcus aureus
•Coagulase-negative staphylococci
 
 
 
•Streptococci
•Enterococci
•Pseudomonas spp
•Enterobacter spp
•Proteus spp
•Escherichia coli
•Serratia spp
•Anaerobes (Finegoldia spp, Clostridium spp, Bacteroides fragilis group)
•Mycobacterium tuberculosis
 
 
•Mycobacterium avium-intracellulare complex
•Rapidly growing mycobacteria
•Dimorphic fungi (blastomycosis, •coccidioidomycosis, •sporotrichosis)
•Candida spp
•Cryptococcus
•Aspergillus spp
•Mycoplasma spp
•Tropheryma whipplei
•Brucella spp
•Salmonella spp
•Actinomyces
 

Common Causes

Causes by Organ System

Cardiovascular Arterial insufficiency ulcer, Polyarteritis nodosa, Thrombophlebitis, Rheumatic fever
Chemical / poisoning No underlying causes
Dermatologic Cellulitis, Marjolin's ulcer, Fanconi like syndrome
Drug Side Effect Daptomycin, Flucloxacillin, Pergolide, Pramipexole
Ear Nose Throat Otitis
Endocrine Diabetic myonecrosis
Environmental No underlying causes
Gastroenterologic Gaucher disease
Genetic Congenital insensitivity to pain with anhidrosis, Gaucher disease, Infantile cortical hyperostosis, Pycnodysostosis, Thick skull syndrome
Hematologic Acute lymphoblastic leukemia, Acute myelocytic leukemia, Deep vein thrombosis, Multiple myeloma, Sickle cell disease
Iatrogenic No underlying causes
Infectious Disease

Bacteria: Arcanobacterium, Bacteremia, Bacteroides, Brucellosis, Campylobacterium sputorum, Cat scratch disease,Congenital syphilis, Enterobacter, Escherichia coli, Group A streptococcal infection, HACEK organism,Haemophilus influenzae, Klebsiella, Melioidosis, Mycobacterium boenickei, Mycobacterium brisbanense,Mycobacterium fortuitum, Mycobacterium goodii, Mycobacterium haemophilum, Mycobacterium houstonense,Mycobacterium lentiflavum, Mycobacterium neworleansense, Mycobacterium ulcerans, Mycobacterium wolinskyi,Neisseria gonorrhoeae, Pasteurella multocida, Pseudomonas, Salmonellosis, Sepsis, Serratia,Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus lugdunensis, Streptococcus pneumoniae,Streptococcus pyogenes, Trench fever, Treponema pallidum, Yaws,Mycobacterium tuberculosis, Actinomycosis,Gas gangrene

Fungi: Apophysomyces, Candida albicans, Coccidioidomycosis, Sporotrichosis

Musculoskeletal / Ortho Albers-Schonberg disease, Avascular necrosis, Brodie abscess, Ewing sarcoma, Fracture

Garre's sclerosing osteomyelitis, Osteosarcoma, Plantar fasciitis, SAPHO syndrome, Septic arthritis, Infantile cortical hyperostosis, Thick skull syndrome, Diabetic myonecrosis, Multiple myeloma

Neurologic Neuroblastoma, Neuropathic joint disease
Nutritional / Metabolic Gout, Pseudogout, Scurvy, Gaucher disease
Obstetric/Gynecologic No underlying causes
Oncologic Cementoblastoma, Primary neuroectodermal tumors, Marjolin's ulcer, Acute lymphoblastic leukemia, Acute myelocytic leukemia, Multiple myeloma, Ewing sarcoma, Osteosarcoma, Neuroblastoma, Fanconi like syndrome
Opthalmologic No underlying causes
Overdose / Toxicity Radium
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal / Electrolyte No underlying causes
Rheum / Immune / Allergy Fanconi like syndrome, Juvenile rheumatoid arthritis, Rheumatic fever, Serum sickness, Synovial osteochondromatosis, Transient synovitis
Sexual No underlying causes
Trauma Cephalhematoma, Nursemaid's elbow, Physical abuse
Urologic No underlying causes
Dental No underlying causes
Miscellaneous Amyloidosis, Animal bite, Bedsore, Eagle syndrome, Ingrown nail

Causes in Alphabetical Order

The unnamed parameter 2= is no longer supported. Please see the documentation for {{columns-list}}.
3

References

Template:WH Template:WS

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