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Microorganism Infection by Indirect Spread via the Bloodstream (Hematogenous Dissemination) 🧩 Meaning Hematogenous dissemination refers to the spread of microorganisms (bacteria, viruses, fungi, parasites) through the bloodstream from a primary site of infection to distant organs or tissues. Unlike direct inoculation (through trauma or surgery), here the pathogen travels via blood circulation and seeds new sites. 🔍 Pathophysiology Primary infection site → e.g., lungs (pneumonia), urinary tract, skin. Microbes enter bloodstream → bacteremia, viremia, fungemia, or parasitemia. Dissemination → carried to distant tissues. Secondary infection → establishment of infection in bone, joints, heart valves, brain, etc. 🦠 Examples of Hematogenous Spread Osteomyelitis: Common in children; bacteria (often Staphylococcus aureus) spread from respiratory or skin infections to bone. Septic arthritis: Bacteria seed the synovial joints via bloodstream. Endocarditis: Bacteria (e.g., Streptococcus viridans, Staphylococcus aureus) infect heart valves after entering blood. Meningitis: Pathogens like Neisseria meningitidis spread from nasopharynx to bloodstream, then to meninges. Tuberculosis: Mycobacterium tuberculosis can disseminate hematogenously to spine (Pott’s disease), kidneys, or brain. Fungal infections: Candida or Aspergillus can spread via blood in immunocompromised patients. ⚖️ Orthopedic Relevance Hematogenous osteomyelitis → especially in children, metaphyseal regions of long bones are affected. Septic arthritis → bloodborne bacteria infect joints, leading to pain, swelling, and destruction. Spinal infections → vertebral osteomyelitis or discitis from hematogenous spread. 🩺 Clinical Importance #bloodstream