Have you heard of osteomyelitis? Understanding this infection will help you recognise its symptoms and seek timely treatment. Osteomyelitis is more common in children and older adults, but it can occur at any age, especially in patients with diabetes or those who are immunocompromised.
This article provides comprehensive information about osteomyelitis, from its causes and symptoms to the available treatment options.
What is Osteomyelitis and What Causes It?
Osteomyelitis is a bone infection caused by bacteria, fungi, or other germs. The infection originates elsewhere in the body and spreads to the bone through the bloodstream. However, it can also occur after injuries that expose the bone, such as open fractures or surgeries. In less common cases, osteomyelitis can be caused by a nearby infection that spreads to the bone, such as a skin or soft tissue infection. Below, we outline the types of osteomyelitis based on the route of infection:
- Infection Through the Bloodstream (Hematogenous): This is the most common form of osteomyelitis, especially in children. Bacteria or other germs can enter the bloodstream from an infection in another part of the body, such as pneumonia, a urinary tract infection, or an infection in another organ.
- Direct infection occurs when an injury, such as an open fracture or deep wound, exposes the bone to germs. Surgery can also increase the risk of osteomyelitis if the bone is exposed during the procedure.
- Contiguous Infection: Infections in the skin, soft tissues, or nearby joints can spread to the bone, causing osteomyelitis.
What Are the Symptoms of Osteomyelitis?
The symptoms of osteomyelitis can vary significantly depending on the patient’s age, the infection’s location, the disease’s severity, and whether the osteomyelitis is acute or chronic. Be vigilant for any signs of bone infection and seek medical attention if you experience any of these symptoms.
In children, acute osteomyelitis often presents with more evident and systemic symptoms. Below, we outline these symptoms:
- High Fever: A common sign of infection and often one of the first symptoms of osteomyelitis in children.
- Irritability: Children with osteomyelitis may be unusually irritable or restless.
- Fatigue and Lethargy: The infection can cause fatigue and lethargy, making the child feel tired and lacking energy.
- Severe Pain in the Affected Area: Bone pain can be intense and localised to the area of infection. The child may avoid moving the affected limb or refuse to walk.
- Swelling, Redness, and Warmth in the Affected Area: These are classic signs of inflammation and may indicate an infection in the bone or surrounding tissues.
In adults, the symptoms of acute osteomyelitis may be more subtle and localised. Below, we outline these symptoms:
- Dull, Deep Pain in the Affected Bone: The pain may be constant or intermittent and worsen with movement or pressure.
- Swelling, Redness, and Tenderness in the Affected Area: These signs of inflammation may be less pronounced in adults than in children but are usually present.
- Fever: This may occur but is less common in adults with osteomyelitis.
- Night Sweats: Excessive sweating during the night can be a symptom of infection.
- Fatigue: Fatigue and a general feeling of malaise may also be present.
In chronic osteomyelitis, the symptoms may be even more subtle and can develop gradually over weeks or months. Below, we outline these symptoms:
- Persistent Pain in the Affected Bone: The pain may be dull and constant or intermittent and worsen with activity. It often worsens at night.
- Drainage of Pus Through the Skin: The infection can cause abscesses in the bone that drain pus through fistulas to the skin.
- Redness, Swelling, and Warmth in the Affected Area: These signs of inflammation may be present but are often much less pronounced than in acute osteomyelitis.
- Fever: This is rare in chronic osteomyelitis.
How is Osteomyelitis Diagnosed?
The diagnosis of osteomyelitis typically involves a combination of several tests. Below, we outline these:
- Physical Examination: The doctor will examine you for signs of infection, such as swelling, redness, tenderness, and limited movement.
- Blood Tests: These may show signs of infection, such as an elevated white blood cell count or increased erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels.
- Imaging Tests: X-rays, computed tomography (CT) scans and bone scans can help visualise the affected bone and identify the presence of infection, with magnetic resonance imaging (MRI) being the most sensitive test.
- Bone Biopsy: In some cases, a bone biopsy may be performed to obtain a sample of bone tissue and analyse it for bacteria or other germs.
How is Osteomyelitis Treated and What Bacteria Cause It?
The treatment of osteomyelitis generally involves a combination of antibiotics and, in some cases, surgery. Antibiotics are administered intravenously or orally, depending on the severity of the infection. The duration of antibiotic treatment can range from several weeks to several months. The most common bacteria causing osteomyelitis is Staphylococcus aureus, though other bacteria, such as Escherichia coli and Pseudomonas aeruginosa, are also frequent culprits.
Surgery may be necessary to drain pus or abscesses, remove infected bone tissue, or stabilise the affected bone. In chronic osteomyelitis, surgery may be more extensive and require reconstruction of the affected bone with bone grafts or prosthetics.
Can Chronic Osteomyelitis Be Cured?
Chronic osteomyelitis is challenging to manage and may require long-term treatment. While chronic osteomyelitis can be cured in some cases, in others, it may persist or recur despite treatment. The severity of osteomyelitis varies depending on the extent of the infection, the patient’s overall health, and their response to treatment. In some cases, osteomyelitis can lead to serious complications, such as the spread of the infection to other parts of the body or even sepsis. In severe cases, amputation may be necessary.
How Can I Prevent Osteomyelitis?
While it’s not always possible to prevent osteomyelitis, there are steps you can take to reduce your risk. Below, we outline some recommendations:
- Care for Wounds Properly: Clean and cover skin wounds to prevent infections.
- Seek Medical Attention for Infections: Do not self-medicate; let a specialist prescribe the most appropriate antibiotic.
- Maintain a Healthy Immune System: A healthy diet, regular exercise, and adequate sleep can help strengthen your immune system.
Osteomyelitis is a bone infection that requires prompt medical attention. If you experience symptoms such as bone pain, swelling, redness, or fever, it’s essential to consult a doctor for an accurate diagnosis and appropriate treatment. HM Hospitales has a team of infectious disease specialists who can provide the comprehensive care you need. Don’t hesitate to contact us to schedule a consultation.
Remember: This article is for informational purposes only and does not replace medical consultation. If you have any concerns, consult a healthcare professional.
