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Anthony R. Berendt

and Martin McNally


May 29, 2014: This chapter has been re-evaluated and remains up-to-date. No changes have been necessary.

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date: 19 September 2021

Bacteria can obtain access to bone from a contiguous focus of infection (e.g. a diabetic foot ulcer) or by haematogenous spread. Osteomyelitis is most commonly caused by Staphylococcus aureus, β‎-haemolytic streptococci, and—in some situations—aerobic Gram-negative rods. An acute inflammatory response causes oedema within bone and soft tissue, and thrombosis in vessels that can result in bone infarction. Pus may form within cancellous bone and beneath the periosteum, stripping it from the bond and leading to extensive necrosis that sometimes involves an entire bone. The process may become chronic and relapsing....

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