<prompt> Most common organism in drug abusers chronic osteomyelitis isStaph.aureusPseudomonasGranulmatousklebsiella  <response>: Pseudomonas 447-current diagnosis Treatment 4thMost common Organism in Osteomyelitis Acute osteomyelitis- children under 4 years of age. H. influenzae Acute osteomyelitis in older children, adults - Staph.aureus Sickle cell disease - Salmonella Heroin addicts and immunocompromized - Pseudomonas, aeruginosa, proteus mirabilis, Bacteroids Sub acute haematogenous osteomyelitis - Staph, aureus Post traumatic osteomyelitis, Infected metal implants Staph, aureus Post operative osteomyelitis - Mixed infection Staph, aureus Proteus, Pseudomonas Osteomyelitis of the spine - Staph, aureus, Pseudomonas aeruginosa Squamous cell carcinoma arising from a chronic osteomyelitis - occurs in areas of bum scars, chronic pressure ulcers, and ostomies as well as as sites of chronic draining osteomyelitisStable chronic osteomyelitis for an average of approximately 20 years 447-CDT- orthopedics 4th Earliest site of bone involvement in hematogenous osteomyelitis is - MetaphysisMarkers of Bone formationMarkers of Bone resorption Serum bone specific alkaline phosphatase Serum osteocalcin Serum propeptide or type I procollagen Urine and serum N- telopeptide Urine and serum C- telopeptide Urine total free deoxypyridinoline Urine Hydroxyproline Serum tartarate resistant- Acid phosphatase Serum bone sialoprtein Urine hydroxylysine glycosides Infective endocarditis due to pseudomonas is most commonly seen with IV drug abuse of pentazocinClassification systems for Osteomyelitis1.Traditional system- Acute 2 weeks subacute weeks to months chronic 3months2.Waldvogel system- Hematogenous- Arising from contiguous infection No vascular disease- Vascular disease present chronic3.Cierny- Mader systemAnatomic extent of infection1. Medullary only acute hematogenous2. Superficial cortex continguous spread or soft tissue trauma3. Localized cortical and medullary, mechanically stable4. Diffuse cortical and medullary mechanically unstable5.Subtype by hosts physiologic statusA HealtyBs Compromised because of systemic factorsB1 Compromised because of local factorsB1s Compromised because of both local and systemic factorsC Treatment worse than the disease 