What is osteomyelitis?

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.

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

A.D.A.M. Medical Encyclopedia. "Osteomyelitis." MedlinePlus, May 30, 2012.

Badash, Michelle, and Rosalyn Carson-DeWitt. "Osteomyelitis." Health Library, September, 2011.

Biddle, Wayne. A Field Guide to Germs. 3d ed. New York: Anchor Books, 2010.

Currey, John D. Bones: Structures and Mechanics. 2d ed. Princeton, N.J.: Princeton University Press, 2006.

"Osteomyelitis." Mayo Foundation for Medical Education and Research, November 20, 2012.

Osteomyelitis: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References. San Diego, Calif.: Icon Health, 2004.

Norden, Carl W., ed. Osteomyelitis. Philadelphia: W. B. Saunders, 1990.

Wilson, Michael, Brian Henderson, and Rod McNab. Bacterial Disease Mechanisms: An Introduction to Cellular Microbiology. New York: Cambridge University Press, 2002.