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Rare bone infections "excluding the spine"
M E Abd El Bagi1, B M Sammak, M S Al Shahed
1Department of Radiology and Imaging, Riyadh Military Hospital, Internal Mail 920 W, P. O. B. 7897, Riyadh 11159, Saudi Arabia.
Abstract:
Bone infections are usually due to haematogenous spread from distant infected organs. Spread of local sepsis or contamination of open wounds are less frequent routes of infection. The commonest cause of osteomyelitis is Staphylococcus aureus. The term rare bone infections refers to diseases where only a few percent affect bone or diseases which are essentially rare; these include bacteria, fungi, parasites and non-specific conditions. Common examples are tuberculosis, salmonellosis, brucellosis, hydatidosis, madura, actinomycosis, aspergillosis and American fungal infections. Certain bone infections have become exceedingly rare, particularly atypical mycobacteria, viral embryopathies and spirochaetes. Rare bone infections are encountered in many parts of the world commonly in the tropics and in the U. S. Immunocompromise and ease of travel can lead to increased incidence. A high index of clinical suspicion is necessary for diagnosis. Specific laboratory diagnosis is not always possible. Radiographs, computed tomography, isotope studies and magnetic resonance are useful but may not make the diagnosis. Aspiration or biopsy is necessary. Rare bone infections may simulate non-infective bone lesions.
Insights
Bone infections, often caused by Staphylococcus aureus, can spread through the bloodstream or wounds. Rare bone infections, including those caused by fungi and parasites, require high clinical suspicion for diagnosis.
Area of Science:
- Infectious Diseases
- Orthopedics
- Microbiology
Background:
- Osteomyelitis commonly arises from Staphylococcus aureus, typically via hematogenous spread.
- Rare bone infections encompass a spectrum of diseases affecting bone, including bacterial, fungal, parasitic, and non-specific conditions.
- Examples of rare bone infections include tuberculosis, salmonellosis, brucellosis, actinomycosis, and various fungal infections.
Purpose of the Study:
- To review the common and rare causes of bone infections.
- To highlight diagnostic challenges and necessary investigations for rare bone infections.
- To emphasize the importance of clinical suspicion in diagnosing these conditions.
Main Methods:
- Literature review of common and rare bone infections.
- Discussion of etiological agents, routes of transmission, and clinical presentation.
- Overview of diagnostic modalities including imaging and biopsy.
Main Results:
- Staphylococcus aureus is the most frequent cause of osteomyelitis.
- Rare bone infections, though infrequent, present diverse etiologies (bacteria, fungi, parasites).
- Diagnostic workup often necessitates imaging (radiographs, CT, MRI, isotope studies) and invasive procedures like aspiration or biopsy.
Conclusions:
- A high index of clinical suspicion is crucial for diagnosing rare bone infections.
- Specific laboratory diagnoses can be challenging, necessitating a combination of methods.
- Rare bone infections can mimic non-infective bone pathologies, complicating diagnosis.