Anaerobic osteomyelitis of long bones

Area of Science:

• Orthopedics
• Infectious Diseases
• Microbiology

Background:

• Osteomyelitis, an infection of the bone, can be caused by anaerobic bacteria, often presenting unique challenges in diagnosis and treatment.
• Understanding the distinct clinical presentations and causative organisms is crucial for managing anaerobic osteomyelitis of long bones.

Observation:

• This review analyzes nine cases of anaerobic osteomyelitis and 52 from existing literature.
• Three primary clinical presentations were identified: acute hematogenous, chronic superinfection of compromised sites, and indolent infections associated with prosthetic devices.

Findings:

• Acute cases typically affect younger patients with previously healthy bones.
• Chronic infections often involve superinfection of fracture sites, frequently with Staphylococcus aureus as an initial aerobic pathogen.
• Indolent infections at prosthetic sites may arise from intraoperative inoculation of cutaneous anaerobic flora, manifesting months to years later.

Implications:

• Successful management necessitates surgical intervention including removal of devitalized tissue, restoration of vascularity, and bone defect grafting.
• Long-term antibiotic therapy, specifically targeting the causative anaerobic organisms with bactericidal agents, is essential for treatment success.