Complications

• septicaemia / pyaemia
• septic arthritis
• direct spread of infection
• deformity or alteration in growth rate due to damage to the growth plate
• amyloidosis
• squamous carcinoma of the skin lining the sinus (Marjolin's ulcer)

Note - in adults, the recurrence rate of chronic osteomyelitis is about 30% at 12 months, but in cases involving P. aeruginosa, the recurrence rate may be as high as 50%. Cases involving prosthetic devices are more difficult to treat, causing increased morbidity due to the need for more surgical procedures and extended antibiotic courses required for treatment.

Reference

1. Calhoun JH, Manring MM. Adult osteomyelitis. Infect Dis Clin North Am. 2005 Dec;19(4):765-86