<prompt> Which among the following is the management of acute osteomyelitis ?Antibiotic treatment soon after taking blood sampleSurgical excision of infected bone.SequestrectomyAmputation  <response>: Ans: a Antibiotics soon after taking blood sample Maheshwari, ed,Revp. 159Broad spectrum antibiotics after taking blood for culture and sensitivity is the initial management of osteomyelitis.Acute osteomyelitis Infection of the bone by micro organisms. Most common site--lower femoral metaphysis upper tibial metaphysis Most common organism--Staph aureus.Clinical featuresAcute onset of pain and swelling at the end of the bone.On examination--classical signs of inflammation present.InvestigationEarliest investigation to pick osteomyelitis is Tc 99 bone scan--it shows increased uptake by bone in metaphysis.Earliest sign in x-ray--Periosteal new bone deposition by 7-10 daysTreatmentWithin 48 hoursRest in a splint or by traction.Broad spectrum antibiotics after taking blood for culture and sensitivity.IV fluids and other supportive measures.DOC-cefotaxime amikacin- X 6 weeks change according to culture and sensitivity reportsAfter 48 hrsSurgical exploration drainageRest, antibiotics and hydrationComplications1 Cc osteomyelitis--commonest complication2 Ac pyogenic arthritis3 Pathological fracture4 Growth disturbance--shortening .lengthening etc 