Osteomyelitis
Osteomyelitis is a secondary infection of the bone and bone marrow, primarily caused by bacterial or fungal infections. It often occurs following an injury, such as a cut or open bone fracture, with Staphylococcus aureus being the most common bacterial culprit. In children, infections may stem from mucous membrane infections or skin sores. The condition typically manifests through symptoms such as fever, drowsiness, dehydration, and localized pain, swelling, and redness in the affected area.
Treatment usually requires hospitalization for intravenous antibiotics, which are preferable to oral medications due to compliance issues. If identified early, treatment can be effective, but severe cases may necessitate surgical intervention to remove infected tissue. Without timely treatment, osteomyelitis can lead to chronic infection, extensive bone damage, or even amputation. Additional therapies, such as hyperbaric oxygen therapy, may be considered for challenging cases to promote healing. Understanding the symptoms and treatment options is crucial for managing this serious condition effectively.
Osteomyelitis
ANATOMY OR SYSTEM AFFECTED: Bones, joints, musculoskeletal system
DEFINITION: A secondary infection of the bone and bone marrow.
CAUSES: Bacterial infection; fungal infection
SYMPTOMS: Fever, drowsiness, dehydration, bone pain, localized swelling and redness, pus
DURATION: Several days to weeks
TREATMENTS: Hospitalization, intravenous antibiotics, surgery
Causes and Symptoms
After a cut, open bone fracture, or puncture wound becomes infected, a secondary infection, caused 80 percent of the time by the bacterium Staphylococcus aureus, can take place. In children, the bacterium usually enters the body via an infection of the mucous membranes in the throat or an infected sore on the body. In the case of a heel puncture, a bacterium that breeds in old athletic shoes, Pseudomonas aeruginosa, can be the culprit. In children, osteomyelitis tends to be located at the growing ends of the long bones in the legs or arms.
![Mycobacterium doricum Osteomyelitis and Soft Tissue Infection. Mycobacterium doricum Osteomyelitis and Soft Tissue Infection, Figure A1. Computed tomography scan of the right lower extremity of a 21-year-old patient, showing abscess formation adjacent to nonunion of a right femur fracture. By April C. Pettit , A. Alex Jahangir, and Patty W. Wright Author affiliations: Vanderbilt University School of Medicine, Nashville, Tennessee, USA [Public domain], via Wikimedia Commons 86194366-28805.jpg](https://imageserver.ebscohost.com/img/embimages/ers/sp/embedded/86194366-28805.jpg?ephost1=dGJyMNHX8kSepq84xNvgOLCmsE2epq5Srqa4SK6WxWXS)
Osteomyelitis is generally accompanied by fever, drowsiness, dehydration, bone pain, and swelling and redness in the affected region. When a joint near the infected area is flexed, severe pain and tenderness can result. With a heel puncture, the heel tends to hurt and swell, but there is often no fever. Over time, the bacteria form pus.
Treatment and Therapy
If osteomyelitis is discovered within seven to ten days from the onset of the infection, large doses of antibiotics can be administered with success. Oral antibiotics are not recommended because compliance is hard to achieve. The recommended daily dose of the antibiotic must be ingested over four to six weeks and can cause severe side effects. Usually, patients are hospitalized and given intravenous antibiotics, which may also be administered at home. During this time, the affected bones should not be exposed to undue stress until easy, pain-free movement is achieved. The injured area may be immobilized. Risks during the time of treatment include broken bones and the onset of severe osteoporosis.
In severe cases or in cases in which the infection was not discovered early, surgery that removes the infected bone or bone marrow is necessary. If the osteomyelitis is not treated, the infection enters the bloodstream and the disease becomes chronic. Extensive bone damage, arthritis, and extrusion of pus will follow. Treatment may involve occasional removal of pus and pieces of dead bone or, in extreme cases, amputation.
For patients with difficult cases of osteomyelitis, hyperbaric oxygen therapy may be administered to deliver more oxygen to the affected bone and thereby speed healing.
Bibliography
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