Osteomyelitis is infection of bone. The bacteria that can cause osteomyelitis are many. They include Staphylococcus aureus, Streptococcus species, Haemophilus, Enterobacter species, and Salmonella species. The bone can get infected either through the infection travelling in the blood stream or from spread of infection from nearby tissue. However, the bone can get infected directly, as in open fractures and surgeries on bones and joints.
In children the infection occurs mainly in the bones of the arms and legs. In adults it occurs more commonly in the spine or vertebrae, and hip. Symptoms include fever, bone pain, general discomfort and malaise, and local swelling, warmth and redness over the affected bones. Osteomyelitis needs to be taken seriously and prompt treatment sought because it can lead to serious complications like bone death, septic arthritis, increased risk of skin cancer if there are open sores, and impaired growth in children.
Treatment is aimed at getting rid of the bone infection, and reducing the damage to the affected bone and the surrounding tissues. Most cases of osteomyelitis respond well to treatment. Treatment is some combination of antibiotics, surgery and hyperbaric oxygen.
Osteomyelitis usually requires prolonged therapy with antibiotics to eliminate the bacterial (in rare cases, fungal) infection. The antibiotic therapy may last weeks to months. You may need to take one or more antibiotics, usually intravenously (through a vein), either in hospital or at home.
Normally, they are given for a minimum period of 4-6 weeks. The antibiotic prescribed will depend on the type of organism causing the infection, as determined by bone biopsy. The side effects of these antibiotics can be diarrhea, nausea and vomiting.
In case the bone damage is extensive, then the diseased bone and other tissue need to be removed. Such a procedure is called debridement. Open space left due to removal of bone tissue needs to be packed with packing material (antibiotic-permeated cement) or bone graft.
This allows new bone tissue to form in that place. The bone used in grafting can be harvested from somewhere else in the body, usually the hip. If the surrounding tissue has been excised, then skin and muscle may need to be grafted.
In severe cases surgery is necessary in addition to antibiotic therapy. The main aim of surgery is to remove the dead bone tissue and drain the pus in case the infection is not responding to antibiotics alone.
Removal Of Foreign Objects
Sometimes the infection may be associated with the presence of surgical screws and plates in the affected area. These would have been placed during an earlier surgery for other reasons. Such foreign objects need to be removed so that they do not act as foci of infection.
If the infection is spreading despite these measures, then you may need amputation as the last resort. Such amputation will most definitely eliminate the infection and prevent its further spread.
However, this needs to be done only when the blood supply to the bones is so compromised that the blood cells that fight infection are not reaching the site in adequate quantities.
There is some evidence that therapy with hyperbaric oxygen can be used instead of surgery in cases not responding adequately to treatment with antibiotics. In this therapy, you will be placed in a chamber that is specially designed.
The chamber will be filled with hyperbaric (at pressures higher than atmospheric) oxygen. Breathing in such oxygen is believed to accelerate the healing and slow down the spread of infection.
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