Text III. Acute Osteomyelitis

Osteomyelitis is an infectious suppurative disease affecting bones. It is caused by Staphylococcus, which reaches the bone via the blood stream from a distant focus, often a throat.

The disease generally affects the upper end of tibia or lower end of femur. The infection is followed by intense reaction, with pus formation in the marrow spaces. From there the suppuration spreads along the marrow cavity and also through the cortex, to erupt on the surface and form a subperiosteal abscess. In some cases the marrow cavity is widely involved; in others, on the contrary, there is a large subperiosteal abscess, but little or no pus within the bone. Almost always part of bone becomes necrotic.

Acute osteomyelitis generally affects children, especially if in poor health, after an infectious fever. In typical case the onset is sudden. Then pain and inflammation of the bone are accompanied by marked toxemia. The temperature rises, often to 103º or 104º F, the face is flushed and the tongue is furred. The leucocyte count rises to 20.000 or more. Delirium is frequent. The pain is severe. The limb is held immobile. The skin over the inflamed region is hot and red. Slight superficial edema appears early.

Acute osteomyelitis is a dangerous disease, especially when it affects a deep-seated bone, such as the upper end of the femur, pelvis or vertebrae. In those who survive the acute phase the disease often persists as chronic osteomyelitis. Eventually complete restoration of functions and general health will be expected in most cases, when appropriate treatment is applied.

27. Read text IV and answer the question “What are the ways of detection of prenatal infections?”.