title: Improvement of chronic osteomyelitis after granulocyte colony stimulating factor.
abstract: BACKGROUND
  chronic osteomyelitis represents a persistent bone and bone marrow infection easy to diagnose in the presence of pain, erythema, swelling, and a draining sinus but more difficult to detect in the absence of the preceding features and with a painful orthopaedic prosthesis.
  
  
  METHODS
  we report upon an elderly gentleman with myelodysplasia requiring revision surgery for a fractured prosthetic left knee. He had clinical, laboratory, and radiological features of chronic osteomyelitis that improved only with administration of granulocyte colony stimulating factor (G-CSF).
  
  
  METHODS
  G-CSF has been successfully employed to treat resistant osteomyelitis in three young patients with primary defects of monocyte and neutrophil killing. A randomized trial confirmed the efficacy of G-CSF in the treatment of chronic osteomyelitis in twenty patients with diabetic foot ulcers and a rat model confirmed the efficacy of G-CSF in acute osteomyelitis.
  
  
  CONCLUSIONS
  our case highlights the usefulness of G-CSF treatment for immune suppressed patients with resistant chronic osteomyelitis.
authors.affiliation: Departments of General Medicine, Airedale General Hospital, Airedale Foundation Trust, Skipton Road, Steeton, BD20 6TD UK.
authors.forename: Michael I
authors.initials: MI
authors.lastname: Pearce
authors.affiliation: Departments of Haematology/Rheumatology, Airedale Foundation Trust, Steeton, UK.
authors.forename: Ann
authors.initials: A
authors.lastname: Cuthbert
authors.affiliation: Departments of Radiology, Airedale Foundation Trust, Steeton, UK.
authors.forename: Guy
authors.initials: G
authors.lastname: Porter
authors.affiliation: Departments of Haematology/Rheumatology, Airedale Foundation Trust, Steeton, UK.
authors.forename: Paul R J
authors.initials: PR
authors.lastname: Ames