Chronic osteomyelitis may be due to the presence of intracellular bacteria (inside bone cells).[8] Also, once intracellular, the bacteria are able to escape and invade other bone cells.[9] At this point, the bacteria may be resistant to some antibiotics.[10] These combined facts may explain the chronicity and difficult eradication of this disease, resulting in significant costs and disability, potentially leading to amputation. Intracellular existence of bacteria in osteomyelitis is likely an unrecognized contributing factor to its chronic form.