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Osteomyelitis

Osteomyelitis involves infection in bone. It is an extremely uncommon and serious condition. Bones can become infected with bacteria when an infection spreads from one body area to bone and when the person develops an open fracture in which bacteria from the outside will infect the interior of bone.

The most common cause of osteomyelitis is an infection with Staphylococcus aureus, which is a common bacterium in the environment and in the mouth. Patients who suffer from poor immunity and diabetes are at increased risk of getting osteomyelitis.

Osteomyelitis is rare; only two out of every 10,000 persons will get osteomyelitis in their lifetime. Both adults and children will get the disease but they get it in different manners. Those situations that allow the immune system to weaken will increase the osteomyelitis risk. These things that increase risk include:

• Having diabetes
• HIV diseases
• Rheumatoid Arthritis
• Sickle cell anemia
• Being an alcoholic
• Long term steroid use
• IV drug abuse
• Bone surgery patients, such as knee and hip replacements

In kids, osteomyelitis occurs very quickly which makes it easier to treat and makes for a much better outcome. Adults are more likely to get chronic osteomyelitis, especially in the leg or arm bones. Adults can have acute osteomyelitis or chronic osteomyelitis. Those with HIV, peripheral vascular disease or diabetes are more likely to have chronic disease; adults can get osteomyelitis of the spine, feet or pelvis.

If you have acute osteomyelitis, it happens over 7-10 days. It takes longer when you have chronic disease but overall, the symptoms are the same and include: nausea, fatigue, fever, irritability, loss of range of motion and tenderness around a swollen bone. If the osteomyelitis is in the vertebral bodies, there can be severe back pain at night.

Doctors need first to diagnose the presence of osteomyelitis. It is a difficult task. Special tests include x-rays and bone scans to see where the bone is affected. At some point, the doctors need to know what the organism is that has caused the infection so that the proper antibiotic can be prescribed.

People can be treated with surgery or antibiotics or both. If the antibiotics work quickly then surgery is unnecessary. It usually takes several weeks of antibiotics given by IV. Pills can be used later.

Chronic or serious infections need surgery to get rid of any infected tissue and hard bone. The surgery stops the infection from spreading within the bone.

Doctors prevent osteomyelitis by keeping surgical areas clean and cleaning cuts and fractures. All open wounds should be flushed out for at least five minutes. Wounds should be bandaged in a sterile bandage. Chronic osteomyelitis needs careful medical attention. Diabetics should be careful to check their feet and care for any open areas.

If osteomyelitis missed or if it is incorrectly treated, the following complications can occur:

• The patient might get recurrent osteomyelitis. This usually occurs because the underlying conditions are not addressed If the circulation is poor or if the immune system is lacking in strength, chronic osteomyelitis can be difficult to take care of. If a person has had a previous case of osteomyelitis, it is possible to get recurrent osteomyelitis.
• An amputation is considered the last ditch effort in taking care of chronic osteomyelitis, especially if there is known to be poor circulation to the affected bone. When blood supply is poor, there are fewer cells that counteract infection available and the poor circulation leads to death of the tissue, including bone. Gangrene can develop, which involves areas of dead tissue. This part of the bod needs to be cut off in order to save the rest of the healthy tissue and bone.