Skip to main content
SpringerLink
Log in

Infektionen des Knochens

  • Living reference work entry
  • First Online:
DGIM Innere Medizin

Part of the book series: Springer Reference Medizin ((SRM))

  • 587 Accesses

Zusammenfassung

Der Erregereintrag in Knochen und Gelenke erfolgt endogen (hämatogen) durch Streuung von einem infektiösen Primärherd oder exogen (posttraumatisch, postoperativ). Klinische Manifestationen treten als Osteitis/Osteomyelitis, Spondylodiszitis, Gelenkinfektionen und Protheseninfektionen auf. Risikofaktoren für Knocheninfektionen sind allgemein hohes Lebensalter, Gelenkerkrankungen, schwere internistische Vorerkrankungen, Gelenkprothesen sowie Traumata. Entscheidend für eine erfolgreiche Antibiotikatherapie ist ein Erregernachweis, weshalb dieser vor Beginn einer Antibiotikatherapie angestrebt werden sollte. Ein weiteres Problem in der Substanzauswahl bei der Therapie von Knocheninfektionen stellt die Knochengängigkeit von Antiinfektiva dar.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

Literatur

  • Al Nammari SS et al (2008) Septic arthritis in haemodialysis patients: a seven-year multi-centre review. J Orthop Surg (Hong Kong) 16:54–57

    CAS  Google Scholar 

  • Atkins BL et al (1998) Prospective evaluation of criteria for microbiological diagnosis of prostheticjoint infection at revision arthroplasty. J Clin Microbiol 36:2932–2939

    PubMed Central  CAS  PubMed  Google Scholar 

  • Babouee Flury B et al (2014) Is switching to an oral antibiotic regimen safe after 2 weeks of intravenous treatment for primary bacterial vertebral osteomyelitis? BMC Infect Dis 14:226

    Article  PubMed Central  PubMed  Google Scholar 

  • Berbari EF et al (1998) Risk factors for prosthetic joint infection: case-control study. Clin Infect Dis 27:1247–1254

    Article  CAS  PubMed  Google Scholar 

  • Berbari EF et al (2006) Outcome of prosthetic joint infection in patients with rheumatoid arthritis: the impact of medical and surgical therapy in 200 episodes. Clin Infect Dis 42:216–223

    Article  PubMed  Google Scholar 

  • Bernard L et al, On behalf of the Duration of Treatment for Spondylodiscitis (DTS) study group (2014) Antibiotic treatment for 6 weeks versus 12 weeks in patients with pyogenic vertebral osteomyelitis: an open-label, non-inferiority, randomised, controlled trial. Lancet. pii: S0140-6736(14) 61233-2

    Google Scholar 

  • Bodmann K-F, Grabein B, die Expertenkommission der Paul-Ehrlich-Gesellschaft fur Chemotherapie e.V (2010) Empfehlungen zur kalkulierten parenteralen Initialtherapie bakterieller Erkrankungen bei Erwachsenen – Update 2010 S 62

    Google Scholar 

  • Bongartz T et al (2008) Incidence and risk factors of prosthetic joint infection after total hip or knee replacement in patients with rheumatoid arthritis. Arthritis Rheum 59:1713–1720

    Article  PubMed Central  PubMed  Google Scholar 

  • Choong PF et al (2007) Risk factors associated with acute hip prosthetic joint infections and outcome of treatment with a rifampin-based regimen. Acta Orthop 78:755–765

    Article  PubMed  Google Scholar 

  • Darouiche RO et al (1994) Osteomyelitis associated with pressure sores. Arch Intern Med 154:753–758

    Article  CAS  PubMed  Google Scholar 

  • Del Pozo JL et al (2009) Infection associated with prosthetic joints. N Engl J Med 361:787–794

    Article  PubMed Central  PubMed  Google Scholar 

  • Dowsey MM et al (2008) Obesity is a major risk factor for prosthetic infection after primary hip arthroplasty. Clin Orthop Relat Res 466:153–158

    Article  PubMed Central  PubMed  Google Scholar 

  • Dubost JJ et al (2014) Three-decade trends in the distribution of organisms causing septic arthritis in native joints: Single-center study of 374 cases. Joint Bone Spine 81(5):438–440

    Article  PubMed  Google Scholar 

  • Eder L et al (2005) Clinical features and aetiology of septic arthritis in northern Israel. Rheumatology (Oxford) 44:1559–1563

    Article  CAS  Google Scholar 

  • Esteban J et al (2008) Evaluation of quantitative analysis of cultures from sonicated retrieved orthopedic implants in diagnosis of orthopedic infection. J Clin Microbiol 46:488–492

    Article  PubMed Central  PubMed  Google Scholar 

  • Favero M et al (2008) Rheumatoid arthritis is a major risk factor for septic arthritis in rheumatological settings. Autoimmun Rev 8(1):59–61

    Article  CAS  PubMed  Google Scholar 

  • Geirsson AJ et al (2008) Septic arthritis in Iceland 1990–2002; increasing incidence due to iatrogenic infections. Ann Rheum Dis 67:638–643

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Gold RH et al (1991) Bacterial osteomyelitis: findings on plain radiography, CT, MR, and scintigraphy. AJR Am J Roentgenol 157:365–370

    Article  CAS  PubMed  Google Scholar 

  • Gouliouris T et al (2010) Spondylodiscitis: update on diagnosis and management. J Antimicrob Chemother 65:11–24

    Article  Google Scholar 

  • Grammatico L et al (2008) Epidemiology of vertebral osteomyelitis (VO) in France: analysis of hospital-discharge data 2002-2003. Epidemiol Infect 136:653–660

    PubMed Central  CAS  PubMed  Google Scholar 

  • Gupta MN et al (2001) A prospective 2 year study of 75 patients with adult-onset septic arthritis. Rheumatology 40(1):24–30

    Article  CAS  PubMed  Google Scholar 

  • Gupta MN et al (2003) Prospective comparative study of patients with culture proven and high suspicion of adult onset septic arthritis. Ann Rheum Dis 62:327–331

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Howard CB et al (1994) Fineneedlebone biopsy to diagnose osteomyelitis. J Bone Joint Surg Br 76:311–314

    CAS  PubMed  Google Scholar 

  • Jamsen E et al (2009) Risk factors for infection after knee arthroplasty: a register-based analysis of 43,149 cases. J Bone Joint Surg Am 91:38–47

    Article  PubMed  Google Scholar 

  • Jamsen E et al (2013) The decline in joint replacement surgery in rheumatoid arthritis is associated with a concomitant increase in the intensity of anti-rheumatic therapy: a nationwide register-based study from 1995 through 2010. Acta Orthop 84:331–337

    Article  PubMed Central  PubMed  Google Scholar 

  • Kaandorp C et al (1997) Incidence and sources of native and prosthetic joint infection: a community based prospective survey. Ann Rheum Dis 56:470–475

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Kowalski TJ et al (2006) Do followup imaging examinations provide useful prognostic information in patients with spine infection? Clin Infect Dis 43:172–179

    Article  PubMed  Google Scholar 

  • Landersdorfer CB et al (2009) Penetration of antibacterials into bone – pharmacokinetic, pharmacodynamic and bioanalytical considerations. Clin Pharmacokinet 48:89–124

    Article  CAS  PubMed  Google Scholar 

  • Lew DP et al (2004) Osteomyelitis. Lancet 364(9431):369–379. Review

    Article  CAS  PubMed  Google Scholar 

  • Love C et al (2000) Diagnosing spinal osteomyelitis: a comparison of bone and Ga-67 scintigraphy and magnetic resonance imaging. Clin Nucl Med 25:963–977

    Article  CAS  PubMed  Google Scholar 

  • Lynn MM et al (2012) Advances in the management of bacterial septic arthritis. Int J Clin Rheumatol 7(3):335–342

    Article  CAS  Google Scholar 

  • Marculescu CE et al (2006) Fungi, mycobacteria, zoonotic and other organisms in prosthetic joint infection. Clin Orthop Relat Res 451:64–72

    Article  PubMed  Google Scholar 

  • McHenry MC et al (2002) Vertebral osteomyelitis: long-term outcome for 253 patients from 7 Clevelandarea hospitals. Clin Infect Dis 34:1342–1350

    Article  PubMed  Google Scholar 

  • Moenster RP et al (2013) The potential role of newer gram-positive antibiotics in the setting of osteomyelitis in adults. J Clin Pharm Ther 38:89–96

    Article  CAS  PubMed  Google Scholar 

  • Mylona E et al (2009) Pyogenic vertebral osteomyelitis: a systematic review of clinical characteristics. Semin Arthritis Rheum 39:10–17

    Article  CAS  PubMed  Google Scholar 

  • Navarro AS (2009) Relevance of antibacterial distribution – the particular case of bone penetration. Clin Pharmacokinet 48:129–130

    Article  CAS  PubMed  Google Scholar 

  • Osmon DR et al (2013) Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 56:e1–e25

    Article  PubMed  Google Scholar 

  • Palestro CJ et al (2006) Infection and musculoskeletal conditions: imaging of musculoskeletal infections. Best Pract Res Clin Rheumatol 20:1197–1218

    Article  PubMed  Google Scholar 

  • Peersman G et al (2001) Infection in total knee replacement: a retrospective review of 6489 total knee replacements. Clin Orthop Relat Res 392:15–23

    Article  PubMed  Google Scholar 

  • Peters AM (1998) The use of nuclear medicine in infections. Br J Radiol 71:252–261

    Article  CAS  PubMed  Google Scholar 

  • Pigrau C et al (2005) Spontaneous pyogenic vertebral osteomyelitis and endocarditis: incidence, risk factors, and outcome. Am J Med 118:1287

    Article  PubMed  Google Scholar 

  • Piper KE et al (2009) Microbiologic diagnosis of prosthetic shoulder infection by use of implant sonication. J Clin Microbiol 47:1878–1884

    Article  PubMed Central  PubMed  Google Scholar 

  • Pulido L et al (2008) Periprosthetic joint infection: the incidence, timing, and predisposing factors. Clin Orthop Relat Res 466:1710–1715

    Article  PubMed Central  PubMed  Google Scholar 

  • Robiller FC et al (2000) Chronic osteomyelitis of the femur: value of PET imaging. Eur Radiol 10:855–858

    Article  CAS  PubMed  Google Scholar 

  • Saleh-Mghir A et al (2011) Adjunctive rifampin is crucial to optimizing daptomycin efficacy against rabbit prosthetic joint infection due to methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 55:4589–4593

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Santiago Restrepo C et al (2003) Imaging of osteomyelitis and musculoskeletal soft tissue infections: current concepts. Rheum Dis Clin North Am 29:89–109

    Article  CAS  PubMed  Google Scholar 

  • Saux MC et al (1982) Bone diffusion of trimethoprim and sulfamethoxazole high pressure liquid chromatography. Pathol Biol (Paris) 30:385–388

    CAS  Google Scholar 

  • Seghrouchni K et al (2012) Remission after treatment of osteoarticular infections due to Pseudomonas aeruginosa versus Staphylococcus aureus: a case-controlled study. Int Orthop 36(5):1065–1071

    Article  PubMed Central  PubMed  Google Scholar 

  • Sendi P, Zimmerli W (2012) Antimicrobial treatment concepts for orthopaedic device-related infection. Clin Microbiol Infect 18:1176–1184

    Article  CAS  PubMed  Google Scholar 

  • Sendi P et al (2008) Spinal epidural abscess in clinical practice. QJM 101:1–12

    Article  CAS  PubMed  Google Scholar 

  • Stengel D et al (2001) Systematic review and meta-analysis of antibiotic therapy for bone and joint infections. Lancet Infect Dis 1:175–188

    Article  CAS  PubMed  Google Scholar 

  • Trampuz A et al (2007) Sonication of removed hip and knee prostheses for diagnosis of infection. N Engl J Med 357:654–663

    Article  CAS  PubMed  Google Scholar 

  • Uçkay I et al (2013) Short parenteral antibiotic treatment for adult septic arthritis after successful drainage. Int J Infect Dis 17(3), e199

    Google Scholar 

  • Walter G et al (2012) Treatment algorithms for chronic osteomyelitis. Dtsch Arztebl Int 109(14):257–264

    PubMed Central  PubMed  Google Scholar 

  • Wimmer MD et al (2013) Evaluation of an interdisciplinary therapy algorithm in patients with prosthetic joint infections. Int Orthop 37(11):2271–2278

    Article  PubMed Central  PubMed  Google Scholar 

  • Zimmerli W (2010) Clinical practice. Vertebral osteomyelitis. N Engl J Med 362(11):1022–1029

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Infektiologie und Mikrobiologie/Dez. Apotheke, Universitätsklinikum Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Deutschland

    Evelyn Kramme

  2. Medizinische Klinik III, Dez. Apotheke, Universitätsklinikum Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Deutschland

    Julia Thern

Authors
  1. Evelyn Kramme
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Julia Thern
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Evelyn Kramme .

Editor information

Editors and Affiliations

  1. Medizinische Klinik I, Universitätsklinikum Schleswig-Hoslstein, Campus Lübeck, Lübeck, Schleswig-Holstein, Germany

    Hendrik Lehnert

  2. TU Dresden Universitätsklinikum Carl Gustav Carus, Dresden, Germany

    Sebastian M. Schellong

  3. FB Gastroenterologie und Hepatologie, Universitätsklinikum Leipzig Medizinische Klinik und Poliklinik II, Leipzig, Sachsen, Germany

    Joachim Mössner

  4. Krankenhaus Barmherzige Brüder, Regensburg, Germany

    Cornel C. Sieber

  5. Nürnberg, Bayern, Germany

    Walter Swoboda

  6. Universitätsklinikum Giessen und Marburg Klinik für Innere Medizin, Marburg, Hessen, Germany

    Andreas Neubauer

  7. Interdisziplinärer Schwerpunkt für Hämos, Universitätsklinikum Gießen und Marburg, Gießen, Germany

    Bettina Kemkes-Matthes

  8. Klinik für Gastroenterologie,Hepatologie, Medizinische Hochschule Hannover, Hannover, Germany

    Michael P. Manns

  9. Sektion für Molekulare und Klinische Inf, Universitätsklinikum Schleswig-Holstein,, Lübeck, Germany

    Jan Rupp

  10. Abt. Kardiologie und Pneumologie, Universitätsklinikum Göttingen Herzzentrum Göttingen, Göttingen, Germany

    Gerd Hasenfuß

  11. Abt. Nephrologie und Klinische Immunologie, Univ.Klinikum Aachen Medizinische Klinik II, Aachen, Germany

    J. Floege

  12. Universitätsklinikum Köln Klinik I für Innere Medizin, Köln, Germany

    Michael Hallek

  13. Klinik für Pneumologie, Medizinische Hochschule Hannover (MHH) Zentrum Innere Medizin, Hannover, Germany

    Tobias Welte

  14. Klinik u. Poliklinik für Innere Medizin, Universitätsmedizin Greifswald, Greifswald, Germany

    Markus Lerch

  15. Dr.-Horst-Schmidt-Kliniken GmbH, Wiesbaden, Germany

    Elisabeth Märker-Hermann

  16. Klinische Toxikologie, Giftinformation, Universitätsklinikum Mainz II. Medizinische Klinik und Poliklinik, Mainz, Germany

    Ludwig Sacha Weilemann

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this entry

Cite this entry

Kramme, E., Thern, J. (2015). Infektionen des Knochens. In: Lehnert, H., et al. DGIM Innere Medizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54676-1_538-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-54676-1_538-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Online ISBN: 978-3-642-54676-1

  • eBook Packages: Springer Referenz Medizin

Publish with us

Policies and ethics

Search

Navigation