Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- dor inespecífica no local da infecção
- dorsalgia
- mal-estar e fadiga
- inflamação local, eritema ou edema
- febre baixa
- presença de fatores de risco
Outros fatores diagnósticos
- drenagem da ferida e/ou do trato sinusal
- cicatrizes, enxertos prévios
- amplitude de movimento reduzida
- sensação reduzida
- sintomas do trato urinário
- torcicolo
- deformidade dos membros
- sensibilidade à percussão
Fatores de risco
- lesões penetrantes
- contaminação cirúrgica
- uso indevido de substâncias por via intravenosa
- diabetes mellitus
- periodontite
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- contagem leucocitária
- velocidade de hemossedimentação
- proteína C-reativa
- radiografia simples da área afetada
- hemocultura
Investigações a serem consideradas
- biópsia dos ossos guiada ou biópsia dos ossos aberta
- ultrassonografia
- ressonância nuclear magnética (RNM) do osso
- Tomografia computadorizada (TC)
- cintilografia com radionuclídeos
- histologia
Algoritmo de tratamento
osteomielite aguda
osteomielite crônica
Colaboradores
Autores
Adrian Kendal, MA, BMBCh, DPhil, FRCS (Ortho)
Honorary Departmental Clinical Research Fellow
The Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences
Oxford
UK
Declarações
AK declares that he has no competing interests.
Jamie Ferguson, MB ChB (hons), MEd., FRCS (Orth)
Consultant in Trauma and Reconstruction Surgery
The Bone Infection Unit
Nuffield Orthopaedic Centre
Oxford University Hospitals Foundation NHS Trust
Oxford
UK
Declarações
JF received a research grant in 2013 from Bonesupport AB, Lund, Sweden to collect data for a study on antibiotic carriers in osteomyelitis treatment. JF is an author of a number of references cited in this topic.
Tse Hua Nicholas Wong, BSc, MB BS, DPhil, MRCP, FRCPath
Consultant in Infectious Diseases and Microbiology
Buckinghamshire Healthcare NHS Trust
Aylesbury
UK
Declarações
THNW declares that he has no competing interests.
Bridget L. Atkins, MA, MBBS, MSc, FRCPath, FRCP
Consultant
Infectious Diseases, Microbiology and Bone Infection
Oxford University Hospitals NHS Foundation Trust
Oxford
UK
Declarações
BLA is an author of a number of references cited in this topic.
Martin McNally, MB, BCh, MD, FRCSEd, FRCS(Orth)
King James IV Professor and Consultant in Limb Reconstruction
Consultant in Limb Reconstruction
The Bone Infection Unit
Nuffield Orthopaedic Centre
Oxford University Hospitals Foundation NHS Trust
Oxford
UK
Declarações
MM is an executive board member of the European Bone & Joint Infection Society and the Girdlestone Orthopaedic Society. He has performed consultancy work for Bonesupport AB and the Oxford Bone Infection Consultancy. He has received travel expenses from Bonesupport AB and the AO Foundation to attend scientific conferences and symposia. He has received royalties from Oxford University Press for contributions to textbooks. MM is an author of a number of references cited in this topic.
Agradecimentos
Dr Jamie Ferguson, Dr Tse Hua Nicholas Wong, Dr Bridget L. Atkins, Dr Martin McNally, and Mr Adrian Kendal wish to gratefully acknowledge Dr Jason H. Calhoun, Dr Nalini Rao, and Dr M. M. Manring, previous contributors to this topic.
Declarações
JHC, NR, and MMM declare that they have no competing interests.
Revisores
Kristine Johnson, MD
Assistant Professor
Infectious Diseases
Bayview Medical Center
Baltimore
MD
Declarações
KJ declares that she has no competing interests.
Silvano Esposito, MD
Associate Professor
Department of Infectious Diseases
University of Naples
Naples
Italy
Declarações
SE has been reimbursed for attending several conferences and received fees for speaking and running educational programs by Pfizer, Novartis, Wyeth Lederle, Sanofi Aventis, and GSK.
Edward Pesanti, MD
Professor of Medicine
Infectious Diseases Division
University of Connecticut Health Center
Hartford
CT
Declarações
EP declares that he has no competing interests.
Diagnósticos diferenciais
- Câncer ósseo metastático ou osteossarcoma
- Trauma antigo ou novo
- Não união não infectada
Mais Diagnósticos diferenciaisDiretrizes
- Guideline on diagnosis and management of acute haematogenous osteomyelitis in pediatrics
- Standards for the management of open fractures of the lower limb
Mais DiretrizesFolhetos informativos para os pacientes
Osteomielite
Mais Folhetos informativos para os pacientes
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