Osteomyelitis refers to inflammation of bone that is almost always due to infection, typically bacterial. This article primarily deals with pyogenic osteomyelitis, which may be acute or chronic. The incidence of osteomyelitis is under 2% a year (Paluska). Incidence increases with every decade of life. Acute hematogenous osteomyelitis is most commonly seen in children, with 85% of affected individuals usually under the age of 1; the prevalence among children is 1 in 5,000 (King).
Among individuals who have been treated for an episode of acute osteomyelitis, the prevalence of chronic osteomyelitis is about 5% to 25% in the India. Prevalence can be as high as 30% to 40% in individuals with diabetes and 16% after foot puncture (King). Intracellular persistence of the pathogen (Staphylococcus aureus) within the host osteoblast in chronic osteomyelitis cases has been identified. Although biofilm formation on devitalized tissue is the main cause of the clinical quiescence of chronic osteomyelitis, intracellular pathogens may also have a role at some point in the pathogenesis of this disease. This finding may lead to the development of new modalities to treat chronic osteomyelitis