Osteomyelitis Causes

1. Causes: Age related Osteomyelitis organisms
   1. All Ages
      1. Staphylococcus aureus is the most common cause of hematogenous Osteomyelitis in Adults and children
   2. Age under 1 year
      1. Group B Streptococcus
      2. Staphylococcus aureus
      3. Escherichia coli
   3. Age 1 to 16 years
      1. Staphylococcus aureus
      2. Streptococcus Pneumoniae
      3. Streptococcus Pyogenes (Group A Streptococcus)
      4. Kingella kingae
      5. HaemophilusInfluenzae was previously common prior to being part of primary Immunization series
   4. Age over 16 years
      1. Staphylococcus aureus
         1. Most common
         2. MRSA accounts for one third of staphylococcal infections
      2. Other infections (especially contiguous and chronic infections)
         1. Staphylococcus epidermidis
         2. Pseudomonas aeruginosa
         3. Serratia marcescens
         4. Escherichia coli
2. Causes: Mechanism of Injury related Osteomyelitis organisms
   1. Foreign Body
      1. Propionibacterium
      2. Coagulase negative Staphylococcus
   2. Nosocomial Infection
      1. Pseudomonas aeruginosa
      2. Enterobacteriaceae
   3. Human or Animal Bites or fist injuries to mouth
      1. Streptococcus
      2. Anaerobic Bacteria
      3. Pasteurella multocida
      4. Eikenella corrodens
   4. Endemic infection exposure
      1. Brucella
      2. Coxiella burnetii (Q fever)
3. Causes: Comorbid condition related Osteomyelitis organisms
   1. Diabetes Mellitus
      1. Streptococcus
      2. Anaerobic Bacteria
   2. Sickle Cell Anemia
      1. Streptococcus Pneumoniae
      2. Salmonella
   3. Human Immunodeficiency Virus (HIV)
      1. Bartonella henselae
      2. Tuberculosis
   4. Immunocompromised conditions
      1. Aspergillus
      2. Mycobacterium avium-intracellulare
      3. Candida albicans
4. References
   1. Hatzenbuehler (2011) Am Fam Physician 84(9): 1027-33
   2. Boutin (1998) Orthop Clin North Am 29:41-66
   3. Carek (2001) Am Fam Physician 63(12):2413-20
   4. Dirschl (1993) Drugs 45:29-43
   5. Eckman (1995) JAMA 273:712-20
   6. Haas (1996) Am J Med 101:550-61
   7. Lew (1997) N Engl J Med 336:999-1007
   8. Lipsky (1997) Clin Infect Dis 25:1318-26
   9. Gilbert (2001) Sanford Guide Antimicrobial, p. 2-3