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Excerpt
Some bacteria, particularly Staphylococcus aureus, adhere to bone by expressing receptors for components of the bone matrix. S. aureus can survive in the osteoblast; thus intracellular survival of bacteria may explain persistence of bone infection.
Infections associated with prosthetic devices may occur up to 24 months after surgery, or even later in patients infected by low grade pathogens. This form of chronic osteomyelitis may be difficult to diagnose because of the absence of systemic symptoms, the fact that there is often drainage around external fixation pins even in the absence of infection and the difficulty of distinguishing periosteal new bone formation due to healing fractures from infection.
