Unusual complications of osteomyelitis

Abstract

The fact that these malignancies are usually engrafted on an old ulcer, does little to alarm the patient already inured to his osteomyelitis. Usually the disability here is slight or nil. The patient disregards the slight increase in symptoms and just “drops in” to the clinic for a checkup. The findings of chronic discharge, foul odor, pains of a mild nature, the clinical appearance of the lesion and a biopsy report furnish evidence enough that surgery must be instituted. The two cases showing the relatively short drainage period, should impress one with the probability that a low grade osteomyelitis may exist for many years, with an exciting factor such as trauma or infection as the inciting cause. It is hardly conceivable that lowered skin resistance would be a predisposing factor in the malignancies, since perfectly normal skin was present before any clinical appearance of the lesions. It is quite possible that in the other five cases the continued irritation, and poor skin resistance would lead to infection and malignancy. The patients who developed the toxic neuritis show a latent period between the acute onset of the osteomyelitis and the primary surgical intervention during which deafness started, continued and was not arrested nor helped by the treatment of the osteomyelitis. The treatment of skin malignancies by amputation or by wide curettement of the involved parts insures a good result. The first of the toxic neuritis patients developed a brain abscess and succumbed; the second is still living with a complicating amyloidotic condition.