The osteomyelitis of smallpox divides itself into two distinct groups. The first, a rather infrequent complication, is the suppurative type, which occurs as a result of secondary infection. The second is due to the variola itself, occurs during the course of the disease, and has all the histologic characteristics of the typical smallpox lesion. This type of osteomyelitis is nonsuppurative and resembles closely the lesions found in orchitis variolosa. Chiari, 1 in 1892, described osteomyelitis variolosa in detail. In a large number of necropsies on smallpox patients, he found necrotic foci widely distributed through the bone marrow of the long bones and, in a few cases, in the sternum and vertebrae. The lesions were found as early as two days and as late as two months after appearance of the eruption, without any evidence of suppuration, even in the late cases. Although he found this condition in 86 per cent
HUENEKENS EJ, RIGLER LG. OSTEOMYELITIS VARIOLOSAREPORT OF A CASE OBSERVED DURING THE ACUTE STAGE. JAMA. 1926;87(5):295–298. doi:10.1001/jama.1926.02680050005002
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