Última revisão: 30 Out 2021
Última atualização: 24 Mar 2021

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • dor inespecífica no local da infecção
  • 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
  • sensibilidade reduzida na úlcera do pé diabético
  • 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

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. 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.

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