Management of haematogenous bone and joint infection in developing countries

Haematogenous pyogenic bone and joint infection is rarely seen in developed countries, but in the developing world it is still a major and common problem. New forms of acute fulminating osteomyelitis are likely to appear due to immunosuppression in the wake of the worldwide spread of HIV infection, AIDS, and the increased use of steroids, antibiotics, and immune activators. Osteomyelitis due to candida and cryptococcus infection in certain regions, are occasionally observed, whilst osteomyelitis that is resistant to treatment is associated with diabetes mellitus. Bone and joint infections are difficult to cure. This difficulty is related to the presence of bacteria adherent to dead bone and foreign material in many cases, and also to the drug resistance and limited penetration of antibiotics into infected bone. This presentation summarizes present knowledge of bone and joint infection and its management.