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Osteomielitis: enfoque actual
Resumen
Fundamento: la osteomielitis piógena es una enfermedad de tipo infecciosa con manifestaciones locales y generales, el diagnóstico que se realiza es clínico debido a la poca especificidad de los exámenes complementarios, en especial en los primeros estadios de la enfermedad.
Objetivo: actualizar los conocimientos sobre la osteomielitis piógena.
Métodos: la búsqueda de la información se realizó en el periodo de un mes (octubre del 2016) y se emplearon las siguientes palabras: osteomyelitis y bone infections, a partir de la información obtenida se realizó una revisión bibliográfica de un total de 2 145 artículos publicados en las bases de datos PubMed, Hinari, SciELO y Medline mediante el gestor de búsqueda y administrador de referencias EndNote, de ellos se utilizaron 50 citas seleccionadas para realizar la revisión, todas de los últimos cinco años, donde se incluyeron cinco libros.
Desarrollo: se plasma la incidencia de la osteomielitis piógena según zonas anatómicas y porcentajes, así como los factores predisponentes para el desarrollo de esta afección. En relación a los estudios imaginológicos se describen los más empleados y su relación con el tiempo de positividad, así como su porcentaje. Se hace referencia a los pilares de tratamiento apoyados en medidas generales, uso de antimicrobianos y modalidades de tratamiento quirúrgico. Se describen las complicaciones más importantes.
Conclusiones: la osteomielitis piógena es una enfermedad local que ocurre a cualquier edad, para su diagnóstico se debe tener un alto índice de sospecha y aplicar de forma correcta el método clínico, ya que los estudios hematológicos e imaginológicos no son específicos, en especial en los estadios tempranos de la enfermedad.
DeCS: OSTEOMIELITIS/epidemiología; IMAGEN POR RESONANCIA MAGNÉTICA; FIJADORES EXTERNOS; CAUSALIDAD; LITERATURA DE REVISIÓN COMO ASUNTO.
Palabras clave
Referencias
Anakwenze OA, Milby AH, Gans I, Stern JJ, Levin LS, Wapner KL. Foot and ankle infections: diagnosis and management. J Am Acad Orthop Surg. 2012 Nov;20(11):684-93.
Carmody O, Cawley D, Dodds M, Connolly P. Acute haematogenous osteomyelitis in children. Ir Med J. 2014 Oct;107(9):269-70.
Marais LC, Ferreira N, Aldous C, Sartorius B, Le Roux T. A modified staging system for chronic osteomyelitis. J Orthop. 2015 Jun;12(4):184-92.
Chou AC, Mahadev A. Acute bacterial osteomyelitis in children. J Orthop Surg (Hong Kong). 2016 Aug;24(2):250-2.
Memis A, Mutluoglu M, Öztürk S, Kara K, Ay H. Calcaneal osteomyelitis associated with a severe abscess. J Am Coll Clin Wound Spec. 2016 Mar;6(3):53-6.
Taki H, Krkovic M, Moore E, Abood A, Norrish A. Chronic long bone osteomyelitis: diagnosis, management and current trends. Br J Hosp Med (Lond). 2016 Oct;77(Sup10):C161-C164.
Yun HC, Murray CK, Nelson KJ, Bosse MJ. Infection after orthopaedic trauma: prevention and treatment. J Orthop Trauma. 2016 Oct;30 (Suppl 3):S21-S26.
Bueno Barriocanal M, Ruiz Jiménez M, Ramos Amador JT, Soto Insuga V, Bueno Sánchez A, Lorente Jareño ML. Acute osteomyelitis: epidemiology, clinical manifestations, diagnosis and treatment. An Pediatr (Barc). 2013 Jun;78(6):367-73.
Cleveland KB. General principles of infection. En: Canale ST, Beaty JH, editors. Campbell's Operative Orthopaedics. 12 th ed. Philadelphia: Elsevier; 2013. p. 706-19.
Thévenin-Lemoine C, Vial J, Labbé JL, Lepage B, Ilharreborde B, Accadbled F. MRI of acute osteomyelitis in long bones of children: pathophysiology study. Orthop Traumatol Surg Res. 2016 Nov;102(7):831-7.
Ziran BH, Smith WR, Rao N. Orthopedic infections and osteomyelitis. En: Court Brown CM, Heckman JD, McQueen MM, Ricci WM, Tornetta P, editors. Rockwood and Green's Fractures in Adults. 8 th ed. Philadelphia: Wolters Kluwer; 2015. p. 793-818.
Chan BY, Gill KG, Rebsamen SL, Nguyen JC. MR imaging of pediatric bone marrow. Radiographics. 2016 Oct;36(6):1911-30.
Dierig A, Ritz N, Tacke U, Heininger U. Group A Streptococcal suppurative arthritis and osteomyelitis of the shoulder with brachial plexus palsy in a newborn. Pediatr Infect Dis J. 2016 Oct;35(10):1151-3.
Al Hajry M, Al Jumaah S, Almayouf SM. Chronic recurrent multifocal osteomyelitis: a first report from Saudi Arabia. Ann Saudi Med. 2012 Nov-Dec;32(6):611-4.
Vigorita VJ. Orthopaedic pathology. 3 rd ed. Philadephia: Wolters Kluwer; 2016.
Cook GE, Markel DC, Ren W, Webb LX, McKee MD, Schemitsch EH. Infection in Orthopaedics. J Orthop Trauma. 2015 Dec;29 Suppl 12:S19-23.
Dabov GD. Osteomyelitis. En: Canale ST, Beaty JH, editors. Campbell's Operative Orthopaedics. 12 th ed. Philadelphia: Elsevier; 2013. p. 725-45.
Copley LAB, Herring JA. Infections of the musculoskeletal system. En: Herring JA, editor. Tachdjian's Pediatric Orthopaedics. 5 th ed. Philadelphia: Elsevier; 2014. p. 1042-54.
Camillo FX. Infections of the spine. En: Canale ST, Beaty JH, editors. Campbell's Operative Orthopaedics. 12 th ed. Philadelphia: Elsevier; 2013. p. 1956-73.
Fernandes K, George P. Osteomyelitis of femur shaft: a not so common focus for PUO. J Assoc Physicians India. 2016 Jan;64(1):152.
Murillo O, Grau I, Lora-Tamayo J, Gomez-Junyent J, Ribera A, Tubau F, et al. The changing epidemiology of bacteraemic osteoarticular infections in the early 21st century. Clin Microbiol Infect. 2015 Mar;21(3):254.e1-8.
Mariani BD, Martin DS, Chen AF, Yagi H, Lin SS, Tuan RS. Polymerase chain reaction molecular diagnostic technology for monitoring chronic osteomyelitis. J Exp Orthop. 2014 Dec;1(1):9.
Salava JK, Springer BD. Orthopaedic infections. En: Cannada LK, editor. Orthopaedic Knowledge Update: 11. Illinois: Am Acad Orthop Surg; 2014. p. 287-306.
Tyner HL, Virk A, Nassr A, Razonable R. Mycoplasma hominis vertebral spine infection: case report and a review of infections of bone and joints. J Infect Chemother. 2016 Nov;22(11):755-758.
Barrani M, Massei F, Scaglione M, Paolicchi A, Vitali S, Ciancia EM, et al. Unusual onset of a case of chronic recurrent multifocal osteomyelitis. Pediatr Rheumatol Online J. 2015 Dec;13:60.
Hake ME, Oh JK, Kim JW, Ziran B, Smith W, Hak D, et al. Difficulties and challenges to diagnose and treat post-traumatic long bone osteomyelitis. Eur J Orthop Surg Traumatol. 2015 Jan;25(1):1-3.
Moraes FB de, Motta TM, Severin AA, Alencar Faria D de, Oliveira César F de, Souza Carneiro S de. Garré's sclerosing osteomyelitis: case report. Rev Bras Ortop. 2014 Apr;49(4):401-4.
Abdulhadi MA, White AM, Pollock AN. Brodie abscess. Pediatr Emerg Care. 2012 Nov;28(11):1249-51.
Bhattacharyya A, Jha AK, Kumar S, Bhattacharjya B. Outcome of different modalities of surgical management of chronic osteomyelitis of calcaneum. J Indian Med Assoc. 2012 Nov;110(11):825-6.
Franceschini M, Di Matteo A, Bösebeck H, Büchner H, Vogt S. Treatment of a chronic recurrent fistulized tibial osteomyelitis: administration of a novel antibiotic-loaded bone substitute combined with a pedicular muscle flap sealing. Eur J Orthop Surg Traumatol. 2012 Nov;22 Suppl 1:245-9.
McKamy S, Chen T, Lee M, Ambrose PJ. Evaluation of a pediatric continuous-infusion vancomycin therapy guideline. Am J Health Syst Pharm. 2012 Dec;69(23):2066-71.
Arias Arias C, Tamayo Betancur MC, Pinzón MA, Cardona Arango D, Capataz Taffur CA, Correa Prada E. Differences in the clinical outcome of osteomyelitis by treating specialty: orthopedics or infectology. PLoS One. 2015 Dec;10(12):e0144736.
Grammatico-Guillon L, Maakaroun Vermesse Z, Baron S, Gettner S, Rusch E, Bernard L. Paediatric bone and joint infections are more common in boys and toddlers: a national epidemiology study. Acta Paediatr. 2013 Mar;102(3):e120-5.
Sipahioglu S, Askar H, Zehir S. Bilateral acute tibial osteomyelitis in a patient without an underlying disease: a case report. J Med Case Rep. 2014 Nov;8:388.
Johnson JE. Antibiotic treatment and conservative surgery plus short-course antibiotics were similar for diabetic foot osteomyelitis. J Bone Joint Surg Am. 2014 Nov;96(22):1923.
McNally MA, Ferguson JY, Lau AC, Diefenbeck M, Scarborough M, Ramsden AJ, et al. Single-stage treatment of chronic osteomyelitis with a new absorbable, gentamicin-loaded, calcium sulphate/hydroxyapatite biocomposite: a prospective series of 100 cases. Bone Joint J. 2016 Sep;98-B(9):1289-96.
Muldoon EG, Switkowski K, Tice A, Snydman DR, Allison GM. A national survey of infectious disease practitioners on their use of outpatient parenteral antimicrobial therapy (OPAT). Infect Dis (Lond). 2015 Jan;47(1):39-45.
Tuchscherr L, Kreis CA, Hoerr V, Flint L, Hachmeister M, Geraci J, et al. Staphylococcus aureus develops increased resistance to antibiotics by forming dynamic small colony variants during chronic osteomyelitis. J Antimicrob Chemother. 2016 Feb;71(2):438-48.
Dhanoa A, Singh VA, Mansor A, Yusof MY, Lim KT, Thong KL. Acute haematogenous community-acquired methicillin-resistant Staphylococcus aureus osteomyelitis in an adult: case report and review of literature. BMC Infect Dis. 2012 Oct;12:270.
Krishnakumar R, Renjitkumar J. Methicillin-resistant staphylococcus aureus vertebral osteomyelitis following epidural catheterization: a case report and literature review. Global Spine J. 2012 Dec;2(4):231-4.
Batchelder N, So TY. Transitioning antimicrobials from intravenous to oral in pediatric acute uncomplicated osteomyelitis. World J Clin Pediatr. 2016 Aug;5(3):244-50.
Malizos K, Sarma J, Seaton RA, Militz M, Menichetti F, Riccio G, et al. Daptomycin for the treatment of osteomyelitis and orthopaedic device infections: real-world clinical experience from a European registry. Eur J Clin Microbiol Infect Dis. 2016 Jan;35(1):111-8.
Izadi M, Zamani MM, Mousavi SA, Sadat SM, Siami Z, Vais Ahmadi N, Is vancomycine still a choice for chronic osteomyelitis empirical therapy in Iran? Iran Red Crescent Med J. 2012 Dec;14(12):782-6.
Ashizawa N, Tsuji Y, Kawago K, Higashi Y, Tashiro M, Nogami M, et al. Successful treatment of methicillin-resistant Staphylococcus aureus osteomyelitis with combination therapy using linezolid and rifampicin under therapeutic drug monitoring. J Infect Chemother. 2016 May;22(5):331-4.
Ferrari J, Pilkington C. Chronic recurrent multifocal osteomyelitis: the prevalence of lower-limb and foot involvement. J Am Podiatr Med Assoc. 2014 Nov;104(6):583-7.
Lollino N. Sequestrectomy in primary osteomyelitis of the humerus: a new indication for
posterior approach. Tech Hand Up Extrem Surg. 2012 Dec;16(4):247-9.
Caterson EJ, Singh M, Turko A, Weaver MJ, Talbot S. The medial femoral condyle free osteocutaneous flap for osteomyelitis in pilon fractures. Injury. 2015 Feb;46(2):414-8.
Roderick MR, Shah R, Rogers V, Finn A, Ramanan AV. Chronic recurrent multifocal osteomyelitis (CRMO) - advancing the diagnosis. Pediatr Rheumatol Online J. 2016 Aug;14(1):47.
Lu W, Liu G, Li B, Shi N, Zhao J. Combined debridement, bone graft and articular cavity sealing using synovium in treating metaphyseal osteomyelitis involving knee joints. Exp Ther Med. 2013 Jan;5(1):253-256.
Lin CC, Chen CM, Chiu FY, Su YP, Liu CL, Chen TH. Staged protocol for the treatment of chronic tibial shaft osteomyelitis with Ilizarov's technique followed by the application of intramedullary locked nail. Orthopedics. 2012 Dec;35(12):e1769-74.
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