Home Osteomyelitis: Contiguous

Osteomyelitis: Contiguous


Defining Characteristics

Increasing pain, skull/mandible/ small bones hand/ long bones/feet, mild fever, minimal drainage
Diabetic osteomyelitis? Painless (due to peripheral neuropathy in most DM pts) ulcer extending to bone, mild cellulitis, crepitance [If it probes to the bone, it’s osteomyelitis]

Disease Development

Bacterial infection from localized ulceration/ trauma travel further to the bone

Potential Causes

Possible polymicrobial (see diabetic foot ulcer bacteria)
Mixed gram+/-, anaerobes


MOST common in adults

Risk factors

Chronic skin ulcers (arterial sclerotic dz), trauma, diabetes, post-op ortho surgery, chronic edema


Imaging hard to interpret bc surrounding soft tissue inf
Bone scan sometimes reveals contiguous spread from ulcer site
Bone sample for culture

Conventional Treatment

Amputation/ surgical debridement
Abs for 4-8wks (Avoid empiric ab tx)