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Difference between acute and chronic osteomyelitis (bone infection)

Acute osteomyelitis is usually detectable two weeks after infection has taken place. Only inflammation is seen. If acute osteomyelitis is detected and acted upon urgently, and if the antibiotics provided are effective against the infective microbe - i.e. if the microbe is not resistant to the selected antibiotic - acute osteomyelitis can often be halted and reversed.

Already six weeks after infection, the inflammation is typically accompanied by injury to the bone with fragments of dead bone coming off, into the surrounding soft tissue. These are the characteristics of chronic osteomyelitis.

Chronic osteomyelitis can only be treated surgically. Antibiotics alone are not effective.

Osteomyelitis can be caused by infection in the adjacent tissue and by chronic wounds.

Chronic osteomyelitis can lead to the formation of large festering wounds, which can cause sepsis. Please read here for how to control these wounds.

Reference: Panteli M, Giannoudis PV. Chronic osteomyelitis: what the surgeon needs to know. EFORT Open Rev. 2017;1(5):128-135. Published 2017 Mar 13. doi:10.1302/2058-5241.1.000017