Osteomyelitis history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nate Michalak, B.A.

History and Symptoms

Patient History

Hematogenous Osteomyelitis

• Intravenous drug use
• Urinary catheter use
• Bacteremia

Contiguous-focus Osteomyelitis

• Recent open fracture
• Recent orthopedic surgery
• Prosthesis

Osteomyelitis Secondary to Vascular Insufficiency

• Diabetes

• Diabetic patients with soft-tissue inflammation or skin ulcers in the feet

Common symptoms

• Systemic:

• Chills
• Fever
• Malaise

• Local:

• Pain
• Edema
• Erythema
• Warmth

Special Considerations

• Hematogenous long-bone osteomyelitis

• Abrupt onset of high fever (fever is present in only 50% of neonates with osteomyelitis)
• Fatigue
• Irritability
• Malaise
• Restriction of movement (pseudoparalysis of limb in neonates)
• Local edema, erythema, and tenderness

• Hematogenous vertebral osteomyelitis

• Insidious onset
• History of an acute bacteremic episode
• May be associated with contiguous vascular insufficiency
• Local edema, erythema, and tenderness
• Failure of a young child to sit up normally

• Chronic osteomyelitis

• Non-healing ulcer
• Sinus tract drainage
• Chronic fatigue
• Malaise