Chronic Osteomyelitis Case Study
PATHOPHYSIOLOGY OF CHRONIC OSTEOMYELITIS
Red text - signs & symptoms manifested by the client. * - as evidenced by the biopsy result
Analysis: 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
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Decreased immune system (occurrence of colds)
Chronically infected sequestrum remains and produces recurring abcesses (throughout client’s life)
Pain/ Tenderness
Swelling
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
Inflammation
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 & joints)
Bone abcess containing dead bone tissue (sequestrum)*
Inability of cavity to collapse & heal due to bone abcess which is not easy to liquefy and drain
New bone growth (involucrum) forms and surrounds the sequestrum*
Susceptibility to infection
Reoccurrence of infection by travelling & proliferation to the Right radius through the bloodstream
Red text - signs & symptoms manifested by the client. * - as evidenced by the biopsy result
Analysis: 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
Swelling
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
Inflammation
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 & joints)
Bone abcess containing dead bone tissue (sequestrum)*
Inability of cavity to collapse & heal due to bone abcess which is not easy to liquefy and drain
New bone growth (involucrum) forms and surrounds the sequestrum*
Susceptibility to infection
Reoccurrence of infection by travelling & proliferation to the Right radius through the bloodstream