ABSTRACT
Acute infection of bone occurs directly by contamination of an open wound (exogenous) or indirectly by blood-borne (haematogenous) spread. The infection may be bacterial, tubercular, spirochaetal, fungal or parasitic. Haematogenous osteomyelitis is caused by a single organism; exogenous infections may be mixed. The commonest causative organism is Staphylococcus aureus (80%); next come Streptococci, which, with Haemophilus influenzae, are frequently responsible for osteomyelitis in children under 2 years. Gram-negative and anaerobic organisms are commonly isolated after trauma. Patients with sicklecell disease are predisposed to Salmonella infections.
