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April 1984

Chronic Multifocal Symmetrical Osteomyelitis

Am J Dis Child. 1984;138(4):340. doi:10.1001/archpedi.1984.02140420006002

The principle that an infection is the result of an interaction between an infecting agent and a host is often overlooked in the urgent clinical setting where the focus is to determine the agent and select the correct anti-agent drug. In the current literature available to clinicians who care for patients with infections, there is generally excellent information on the infecting agents, on the specific anti-agent drugs, and on the protocol for treatment of "an infection." There is relatively little information on the tissue or organ responses to infection, that is, on the pathogenetic and ultimate pathologic differences in the local responses of specific tissues or organs to specific infecting agents. "Staphylococcus aureus osteomyelitis," for example, is not an adequate diagnosis because the principles and priorities of treatment are different if the process is in the calcaneus or vertebral body, and different again if it involves, eg, the proximal metaphysis