Osteomyelitis

3D Medical Animation Staphylococcus Aureus

Osteomyelitis is the medical term for an infection in a bone.

Signs and symptoms

Signs and symptoms of osteomyelitis vary but may include bone pain, fever, chills, excessive sweating, malaise, or an open wound. People with the condition may also experience local swelling, redness, and warmth at the site of the infection. Although any bone in the body can be affected, the long bones of the arms and legs are most commonly infected in children, while the feet, spine bones, and hips are primarily affected in adults.

Causes

Osteomyelitis is most often caused by a bacterial infection, although it can also be caused by a fungal infection.

Risk factors

Risk factors for the condition include diabetes, poor blood supply, recent injury, intravenous drug abuse, surgery involving the bones, and a weakened immune system. The goal of treatment is to cure the infection and reduce damage to the bone and surrounding tissues. This may include medications to treat the infection and surgery to drain, clean and/or remove dead bone tissue.

Clinical presentation

In some cases, osteomyelitis causes no signs or symptoms. When present, symptoms are often nonspecific and may be blamed on other, more common conditions. People affected by osteomyelitis may experience:

• Bone pain
• Fever and chills
• Excessive sweating
• Malaise
• Open wound
• Local swelling, redness, and warmth
• Irritability or lethargy (especially in young children)

Cause

Osteomyelitis occurs when an infection develops in a bone or spreads to a bone from another area of the body. It is most commonly caused by a bacterial infection (often staphylococcus bacteria), but may occur due to a fungal infection, as well.

Risk factors for the condition include diabetes, poor blood supply, recent injury, intravenous drug abuse, surgery involving the bones, and a weakened immune system.

Inheritance

Osteomyelitis is not inherited. It is an infectious disease caused by bacteria or fungi.

Diagnosis

A diagnosis of osteomyelitis is often suspected based on the presence of suspicious signs and symptoms. For example, a physical examination may show bone tenderness with possible swelling and redness. Additional tests and procedures can then be ordered to confirm the diagnose and to determine what is causing the infection.

Tests may include:

• Blood cultures
• Bone biopsy (which is then cultured)
• Bone scan
• Bone x-ray
• Complete blood count (CBC)
• C-reactive protein (CRP)
• Erythrocyte sedimentation rate (ESR)
• MRI of the bone
• Needle aspiration of the area around affected bones

Treatment

The primary aim of treatment is to address the infection and reduce damage to the affected bone. Antibiotics or anti-fungal medications may be given to destroy the bacteria or fungi that are causing the infection.

Depending on the severity of the condition, surgery may also be needed to remove dead bone tissue. Surgical procedures may involve drainage of the infected area, removal of diseased bone and tissue, restoration of blood flow, or removal of foreign material.

Prognosis

When treatment is received, the outcome for acute osteomyelitis is usually good. The outlook is worse for chronic (long-term) osteomyelitis, even with surgery. Amputation may be needed, especially in diabetics or other patients with poor blood circulation. The outlook is guarded in those who have an infection of a prosthesis.

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