Right Frontotemporal Facial Bone fracture

A 76-year-old African American male presents to your outpatient practice status post 3 months with a nasal and right frontotemporal facial bone fracture that was surgically repaired and grafted following a motor vehicle accident. The patient noticed some abnormal healing and came in to have it evaluated.

On examination you note necrotic, purulent drainage and some bone exposure in the nasal dorsum.

Vitals are stable and patient is afebrile.

You draw some labs and they reveal leukocytosis and an elevated sedimentation rate.

You suspect osteomyelitis and refer back to the surgeon after initiating empiric antibiotic therapy.

Explain the pathophysiology of osteomyelitis to a cellular level and explain the correlated lab findings, include also, why did this geriatric patient remain afebrile?