OSTEOMIELITIS AKUT

dr. Dani Rosdiana, SpPD

Bagian Ilmu Penyakit Dalam
FK Universitas Riau
LATAR BELAKANG
 Osteomielitis: peradangan tulang caused by
organism infection.
 Kejadian : paling banyak pada anak-anak
(predominantly)
 Dewasa: sering sub akut atau kronik
 Trauma, pembedahan, benda asing pada trauma,
prothesa  disrupt bony integrity
 Penjalaran hematogen post bacteriemia.
 prosthetic joints are associated with infection,
microorganisms typically grow in biofilm, which
protects bacteria from antimicrobial treatment
and the host immune response.
INSIDENSI
 Hematogenous >> (20%), lebih banyak pada
laki-laki (why? Unknown)
 Insidensi spinal osteomyelitis diperkirakan 1
in 450,000 pada 2001. namun, overall
incidence vertebral osteomyelitis diperkirakan
akan terus meningkat tahun terakhir karena:
 intravenous drug use
 increasing age of the population
 higher rates of nosocomial infection due to
intravascular devices and other
instrumentation.
Etiology
 Post traumatic osteomyelitis :47% cases
 Other major causes :
 Vascular insufficiency (mostly occurring in
persons with diabetes; 34%)
 Hematogenous seeding (19%).

 Motor vehicle accidents, sports injuries, and the

use of orthopedic hardware to manage trauma.
 Osteomyelitis may complicate puncture wounds
of the foot, occurring in 1.8%-6.4% of patients
following injury.
Osteomielitis Hematogen
 Vertebrae : paling banyak terkena
hematogenous osteomyelitis,
 Long bones, pelvis, and clavicle.
 Microba:
 S aureus : paling banyak  Osteomielitis AKUT
 Pseudomonas Osteomielitis Kronik
 Enterobacteriaceae.
 Jarang: anaerobe gram-negative bacilli.
 Dental extraction has been associated with
Streptococcus viridans infections .
TAMPILAN KLINIK

GEJALA
 Demam, menggigil, lelah, lemah.
 Gejala klasik peradangan : nyeri lokal,
bengkak, merah, dan kadang hilang dalam
waktu 5-7 hari.
 Need to explore: previous antibiotic and
surgical treatment. Local pain, swelling,
erythema, and edema may also be
reported.
 PHYSICAL EXAMINATION
 Scars or local disturbance of wound
healing may be noted along with the
cardinal signs of inflammation.
 Range of motion, deformity, and local
signs of impaired
 Vascularity are also sought in the involved
extremity.
 If periosteal tissues are involved, point
tenderness may be present.