Pathophysiology for Chronic Osteomyelitis

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Red text - signs & symptoms manifested by the client. * - as evidenced by the biopsy result

The client was diagnosed with chronic osteomyelitis on her 2nd confinement after she sought consult for a tender mass growth on her Right radius. Chronic osteomyelitis is an infection of the bone usually caused by extension of soft tissue infection, direct bone contamination from bone surgery or an open fracture or traumatic injury and hematogenous spread from other sites of infection. In the client’s case, it can possibly be traced to her history of fall approximately one year ago that resulted in her first operation ( ). The pathogenic organisms that cause Chronic osteomyelitis can be Staphylococcus aureus (which causes 70% – 80% of bone infections), Proteus and Pseudomonas species and Escherichia coli. Chronic osteomyelitis

Smeltzer, S.C., & Bare, B.G. (2004). Medical – Surgical Nursing 10th Edition Volume 2. Lippincott Williams & Wilkins. Philippines

Decreased immune system (occurrence of colds)

Chronically infected sequestrum remains and produces recurring abcesses (throughout client’s life)

Pain/ Tenderness
Loss of function

Fall (approx. 2 year ago) ago)

Invasion of microorganisms ( Enterobacter eroguenes) through open wound on Left knee (2 years ago)

Microscopic examination shows bone and marrow admixture of inflammatory cells including neutrophils, lymphocytes and plasma cells; marrow fibrosis, focal bone necrosis and new bone formation.

Infection of the joint


Increased ESR (9/13/08): 125mm/hr
Increased ESR (7/2/10): 88mm/hr

Thrombosis of the blood vessel

Ischemia with bone necrosis

Infection extends into medullary cavity (may spread to adjacent soft tissues &...
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