Haematogenous osteomyelitis and Staphylococcus aureus.

Some 80 - 90% of all acute haematogenous osteomyelitis is caused by staphylococcus aureus. We suggest that this is due to the special ability of staphylococci to synthesise prostaglandins from appropriate precursors such as arachidonic acid. Prostaglandins, especially of the E series, are potent stimulators of bone resorption. Establishment of osteomyelitis could thus result from minor bone trauma and local release of prostaglandins and their precursors, followed by adventitious infection. Infection by staphylococcus aureus, but not by other bacteria, could then lead to a sudden surge in prostaglandin production and so bone destruction, facilitating the formation of an osteomyelitic focus.