Musculoskeletal Pathologies: Osteomyelitis NURS 611: Advanced Pathophysiology

OSTEOMYELITIS 2 Musculoskeletal Pathologies: Osteomyelitis Osteomyelitis is a bone infection affecting all ages, from neonates to adults (McCance & Huether, 2019). It is most common in males and ages between three and twelve years old adults (McCance & Huether, 2019). Factors that can predispose a patient to osteomyelitis development include various infections such as impetigo, cerebral abscesses, infected burns, furunculosis, and prolonged intravenous or parenteral nutrition (McCance & Huether, 2019). Typically bone is quite resistant to infection, but osteomyelitis develops from inoculation with a large number of organisms, bone damage, or the presence of hardware or foreign material into the bone (Sopirala, 2020). The pathogenesis is multifactorial and not widely understood, but the degree of severity seems to depend on the pathogen's virulence, the host's immune system, and the vascularity of the bone (Sopirala, 2020). Pathophysiology Osteomyelitis can be divided into two categories based on pathogenesis: hematogenous and nonhematogenous (Sopirala, 2020). Nonhematogenous develops adjacent to a contiguous focus of infection or from direct inoculation of infection into the bone (Sopirala, 2020). Nonhematogenous osteomyelitis develops from direct inoculation of infection into the bone, usually from trauma, surgical intervention, or hardware placement, whereas hematogenous results from microorganisms that settle into the bone causing bacteremia (Sopirala, 2020). Staphylococcus Aureus is the most common pathogen associated with osteomyelitis by promoting bacterial adherence, resistance to host defense, and proteolytic activity (Sopirala, 2020). Staphylococcus Aureus can survive intracellularly in osteoblasts and adhere to various components, including fibrinogen, fibronectin, laminin, and collagen (Sopirala, 2020). When digested by the osteoblasts, the bacteria undergo phenotypic alterations leaving them