Osteomyelitis
Introduction
- Cause: most frequently bacterial but rarely fungal etiology.
- Signs: inflammation, loss of function, pain, bony swelling, deformity, anorexia, weight loss, reduced activity.
- Diagnosis: diagnostic imaging, biopsy, cytology, culture, bloodwork.
- Treatment: antimicrobials.
- Prognosis: good to poor depending on severity.
Presenting signs
- Inflammation.
- Loss of function.
- Pain.
- Bony swelling.
- Deformity.
- Anorexia may be a feature if oral cavity involved.
- Weight loss.
- Reduced activity.
Acute presentation
- Uncommon.
- Firm swelling.
- Paresis (spinal).
Public health considerations
- Zoonotic bacteria can be cultures from osteomyelitis lesions:
- Mycobacteria spp.
- Salmonella.
- Pseudomonas.
Cost considerations
- For optimal outcomes diagnostic investigations are required.
- Long courses of treatment may be required for full recovery and to minimize the risk of recrudescence of infection.
Special risks
- Extension to septicemia can occur if treatment is not instigated promptly or correctly.
Pathogenesis
Etiology
- Most frequently bacterial but rarely fungal etiology, eg Nannizziopsis spp, Aspergillus spp, Mucor spp.
- Aeromonas, Pseudomonas, Salmonella, Mycobacterium spp are common etiologies.
- May result from infection elsewhere, eg pneumonia Pneumonia, bite wound, gingivitis.
Predisposing factors
General
- Most bacterial infections that extend to cause osteomyelitis are opportunistic bacteria infecting an immunocompromised host.
- Husbandry deficiencies or underlying disease process contribute to immune deficiency.
Specific
- Extension of periodontal disease Periodontal disease, stomatitis Stomatitis, traumatic wounds, ulcerative dermatitis, shell infections are commonly implicated in cases of osteomyelitis.
- Septicemic spread of bacteria to skeletal structures is another route of infection.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- De Souza S O et al (2014) Osteomyelitis caused by Salmonella enterica serovar derby in boa constrictor. J Zoo Wildl Med 45 (3), 642-644 PubMed.
- Rothschild B M et al (2014) Paravertebral masses in blue-tailed monitor, Varanus dorianus, indicative of soft-tissue infection with associated osteomyelitis. J Zoo Wildl Med 45 (1), 47-52 PubMed.
- Kolker S et al (2012) Osteomyelitis due to Salmonella enterica subsp. arizonae: the price of exotic pets. Clin Microbiol Infect 18 (2), 167-170 PubMed.
Other sources of information
- Rothschild B M, Schultze H P & Pellegrini R (2012) Summary of Osseous Pathology in Amphibians and Reptiles. In: Herpetological Osteopathology: Annotated Bibliography of Amphibians and Reptiles. Springer Science & Business Media, USA.