Viral infections: Musculoskeletal infection in the human immunodeficiency virus (HIV) infected patient

Summary HIV disease has reached epidemic proportions in Africa over the last decade and is severely stretching the health services of the many poor countries of the region. Increased sepsis during fracture surgery and the late infection of implants impels us to rethink many standard methods of treatment. Musculoskeletal infections, including tropical pyomyositis and long bone haematogenous osteomyelitis, are now common manifestations of advanced HIV disease in adults. Despite their severe infections, such patients may survive for more than 5 years and certainly cannot be written off as terminally ill. Treatment is often prolonged and, in the case of osteomyelitis, may necessitate amputation. These patients now occupy many of the available orthopaedic beds.