Infections of the musculoskeletal system

Infekcije lokomotornog sustava mogu se podijeliti na infekcije bez prisutnosti stranog materijala i na infekcije u prisutnosti stranog materijala. Povećanjem broja operacija ugradnja endoproteza i osteosintetskog materijala raste broj periprotetičkih i posttraumatskih infekcija. Glavnu prepreku uspješnom liječenju infekcija u prisutnosti stranog materijala predstavlja pojava biofilma u kojem su bakterije i 1000 puta otpornije na djelovanje antibiotika. Od infekcija koje zahvaćaju nativnu kost i zglob značajni su osteomijelitis i septički artritis. Osteomijelitis je razarajuća upala kosti uzrokovana bakterijama, gljivama, a u prošlosti često i mikobakterijama. Nastaje endogeno širenjem per continuitatem i hematogenim putem ili egzogeno kod otvorenih ozljeda i operacija. Akutni hematogeni osteomijelitis većinom pogađa djecu dok se egzogeni osteomijelitis češće javlja u odraslih. Ukoliko se akutni osteomijelitis uspješno ne liječi prelazi u kronični oblik. Septički artritis upala je zgloba infektivne etiologije uzrokovana najčešće bakterijskim, ali povremeno gljivičnim, virusnim ili drugim patogenom. Brzo dovodi do destrukcije zgloba stoga su rana dijagnoza i liječenje presudni za očuvanje funkcije zgloba. Spondilodiscitis opisuje infekciju prostora intervertebralnog diska i susjednih kralješaka. U ranim fazama karakteriziran je nespecifičnim kliničkim simptomima poput blage vrućice, opće slabosti i gubitka težine zbog čega često dolazi do kašnjenja u dijagnozi. Od infekcija kože i mekotkivnih struktura razlikujemo jednostavne i komplicirane infekcije. Nekrotizirajući fascitis je akutni brzo napredujući infektivni proces koji se širi površinskom i dubinskom fascijom mišića uzrokujući nekrozu potkožnog tkiva, dermisa i epidermisa. Najčešće se javlja kod starijih osoba s komorbiditetima i imunokompromitiranih. Važno je rano prepoznavanje zbog ozbiljnosti bolesti. Infekcija dijabetičkog stopala definira se kao infekcija mekog tkiva ili kostiju ispod maleola. Najčešća je komplikacija dijabetesa melitusa koja dovodi do hospitalizacije i najčešći uzrok netraumatske amputacije donjih ekstremiteta.Infections of the musculoskeletal system can be divided into infections with or without the presence of foreign material. As the number of operations to install endoprostheses and osteosynthetic material increases so does the number of periprosthetic and posttraumatic infections. The main obstacle to successful treatment of infections in the presence of foreign material is the appearance of a biofilm which makes bacteria 1000 times more resistant to the action of antibiotics. Osteomyelitis and septic arthritis are the most significant infections affecting the native bone and joint. Osteomyelitis is a devastating inflammation of the bones caused by bacteria, fungi, and in the past often by mycobacteria. It occurs endogenously by spreading locally and hematogenously or exogenously with open injuries and surgeries. Acute hematogenous osteomyelitis mostly affects children while exogenous osteomyelitis is more common in adults. If acute osteomyelitis is not successfully treated, it turns into a chronic form. Septic arthritis is an inflammation of the joint of infectious etiology caused most often by a bacterial but occasionally fungal, viral or other pathogen. It quickly leads to joint destruction so early diagnosis and treatment are crucial to preserve joint function. Spondylodiscitis describes an infection of the intervertebral disc space and adjacent vertebrae. In the early stages, it is characterized by nonspecific clinical symptoms such as mild fever, general weakness, and weight loss, which often leads to delays in diagnosis. We distinguish simple and complicated infections of the skin and soft tissues.. Necrotizing fasciitis is an acute rapidly progressive infectious process that spreads to the superficial and deep fascia of the muscles causing necrosis of the subcutaneous tissue, dermis, and epidermis. It most commonly occurs in the elderly with comorbidities and with immunocompromised patients. Early recognition is important due to the severity of the disease. Diabetic foot infection is defined as an infection of the soft tissue or bone beneath the malleolus. It is the most common complication of diabetes mellitus that leads to hospitalization and the most common cause of non-traumatic amputation of the lower extremities