Osteomyelitis is characterized as an acute or chronic inflammatory condition of bone due to secondary infection of bacterial organisms. There are basically two process of contracting osteomyelitis 1) hematogenous infection and 2) direct contiguous infection. Hematogenous osteomyelitis is a secondary bone infection caused by blood bacteriemia seeding infectious bacteria into the bone through the blood stream. This is a common cause of osteomyelitis in children. Over 85% of hematogenous osteomyelitis is reported in children. This infection is most commonly associated with vascular metaphyseal infection in the young, growing bone. Vessels can thrombose and bone will locally necrose from bacterial infection. Direct or contiguous osteomyelitis is the most common cause of bone infection caused by open ulceration in diabetes after a break in the skin barrier. The most common pathogen to cause this infection is staphylococcus aureus. However, ulcerative osteomyelitis is multibacterial in nature with common pathogens such as pseudomonas and streptococcus species as primary and secondary organisms.
