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Osteomyelitis is an infection of the bone or bone marrow caused by bacteria, viruses, fungi and parasites. It can be divided into two categories: acute and chronic. Acute osteomyelitis tends to occur after a break in the skin or ulcer near a bone, while chronic osteomyelitis typically develops slowly over time with no obvious cause.

Pathophysiology of Disease
The pathophysiology of osteomylitis involves inflammation of the infected area due to bacterial invasion. Bacteria most commonly enter through breaks in the skin or ulcers near bones where they will begin to proliferate and spread throughout the surrounding tissue leading to swelling and redness around the affected area as well as pain, fever and malaise. In addition, some bacteria may directly invade healthy tissue resulting in further damage including destruction of blood vessels, necrosis (cell death) and abscess formation.

Clinical Manifestations
Patients with osteomylitis present with signs such as pain at rest or during movement that exacerbates when pressure is applied on that area; fever; tenderness; redness; increased swelling around infected areas; decreased range of motion at affected joint(s); fatigue; nausea/vomiting/diarrhea if systemic symptoms present; abscesses if advanced stage reached. Additionally, if paralysis occurs due to involvement of nerves it can result in difficulty walking or other mobility issues depending on which nerve(s) are affected by the disease process.

Evaluation (Diagnostics)
In order to diagnose patients with suspected cases of osteomyelitis multiple tests are usually necessary for confirmation such as complete blood count (CBC), imaging studies like X-rays/CT scans/MRI scans, aspiration biopsy along with cultures from drained fluid taken via biopsy needle during aspiration techniques which help identify causative organisms responsible for causing infection.

Treatment (Pharmacological & Non-Pharmacological)
Treatment for both acute & chronic forms involve administration antibiotics orally or intravenously depending upon severity & type of infections along antiinflammatory drugs like NSAIDs (nonsteroidal anti-inflammatory drugs). Antifungal & antiviral medications might be prescribed based on specific agents identified through testing prior mentioned above.(1). Alongside pharmacological therapies nonpharmacological approaches must also be undertaken such physical therapy modalities like heat application over infected joints can help reduce pain while cold compresses should be used over inflamed sites temporarily soothe discomfort experienced by patient additionally elevation legs above heart level helps improve circulation decreasing chance development complications arise secondary edema buildup.(2). Surgery may needed remove foreign objects found inside body cavity causing infections draining purulent material from source site possible debridement involved removal dead tissue promote healing.(3). Ultimately goal treatment provide sufficient relief allow normal functioning life avoiding debilitating effects left untreated allow timely diagnosis initiated ensure best course action determined preventing severe complications develop could potentially cost patients lives when delays exist unreported symptoms not addressed soonest convenience .

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