I.

INTRODUCTION

Osteomyelitis is an infection of the bone and surrounding tissues. It occurs most

frequent in the femur, tibia, sacrum, and heels. Infection of the long bones is generally
accompanied by acute localized pain and redness or drainage, often with a history of a
recent trauma or newly acquired prostheses. Fever and malaise may also be present.
(Black, Joyce. Medical Surgical Nursing. Singapore: 2009 8th Edition)

Although generally bacterial in origin, osteomyelitis can also be caused by a virus

or fungus. Staphylococcus aureus is the most common infecting microorganisms, but
Escherichia coli (E. coli), Pseudomonas, Salmonella may also be found.

Following inadequate treatment of acute osteomyelitis, the condition may

become chronic. Chronic osteomyelitis represents an infection that is well established in
bone and has been present for several weeks, months, or years. (cal.vet.uppen.edu)

Although chronic osteomyelitis resulting from untreated acute osteomyelitis is no

longer often seen in developed countries, it is still relatively common as a sequelae from
open fractures or gunshot wounds. The classic form of chronic osteomyelitis had its
onset with acute osteomyelitis, as the abscess was forming and the involved bone was
ischemic. If the amount of ischemic bone was substantial, it would remain as a
sequestrum. Especially if the sequestrum was contaminated, it would remain as a focus
of recurring infection; even if not contaminated, it's presence activated a host response
similar to that of a foreign body -an attempt to wall off the sequestrum. Chronic
osteomyelitis is clinically evident by low grade drainage and inflammation about the
infected

site.

Pathologic

fracture

osteomyelitis. (www.posna.org)

or

nonunion

may

accompany

chronic

A. Background of the Case Study

This is a case of a y / o patient suffering from chronic osteomyelitis. Males are

most affected more often than females. Susceptibility to infection increases with
diabetes, immunocompromising diseases, or a history of bloodstream diseases.
Osteomyelitis also develops in pressure ulcers and other chronic open wounds. Limiting
the spread of osteomyelitis may also be more difficult in clients with a disorder such as
malnutrition, alcoholism, or liver failure. (Black, Joyce. Medical Surgical Nursing.
Singapore: 2009 8th Edition)

B. Objectives of the Case Study

1. To enhance knowledge and acquire more information about chronic

osteomyelitis.
2. To convey the significance of patients response to the rendered nursing
intervention.
3. To provide concrete information with regards to the patients condition.

C. Significance of the Case Study

This case study will help the group in understanding the disease process of the
patient. This will help the group in identifying the primary needs of the patient with
chronic osteomyelitis. By identifying such needs and health problems, the group can
formulate a nursing care plan for the patient that would address the needs and
problems effectively. This case study would also equip the group with knowledge, skills
and attitude on how to manage future patients with similar disease.

D. Scope and Delimitation

The data presented in this case was primarily obtained from nurse patient
interaction as well as with the significant other who partly served as informant. Further
information is based on the patients chart. This study focused only on nursing care
management in a patient with chronic osteomyelitis. The study only shows the
procedures that have been done to the patient, nursing management that took place,
medications which have been given and nurse patient interactions during our shift.