Osteomyelitis

DEFINITION

• Osteomyelitis (OM): infection of the bone.
  • Acute OM: first presentation of osteomyelitis, < 2 weeks duration, no bony necrosis/sequestrum, usually hematogenously acquired and more commonly seen in children.
  • Chronic OM: not clearly defined but may include failure of prior OM treatment, symptoms >3 weeks, presence of necrotic bone/sinus tract or discharge.
    • Diagnosis often difficult, especially with pressured decision-making in hospital settings, or outpatient evaluations without easy access to willing sub-specialists/diabetic foot infection (DFI)-comprehensive management teams.
• No robust evidence to back definitions or guidelines for treatment of OM in the setting of DFI.
• Two general categories of OM:
  • Occurring within the context of DFI (most common by far)
  • Other sites, e.g., vertebral.