Osteomyelitis is an infection in a bone that causes inflammation of the bone and or bone marrow. Infections can reach a bone by traveling through the bloodstream or spreading from nearby tissue. Infections can also begin in the bone itself if an injury like a fracture or puncture exposes the bone to germs.
Osteomyelitis is an uncommon, but a very serious condition. Smokers and people with chronic health conditions, such as diabetes or kidney failure, are more at risk of developing osteomyelitis. People who have diabetes may develop osteomyelitis in their feet if they have foot ulcers.
Signs and symptoms of osteomyelitis include fever and chills; swelling, warmth and redness over the area of the infection; pain in the area of the infection; and fatigue.
Sometimes osteomyelitis causes no signs and symptoms or the signs and symptoms may be hard to distinguish from other problems in the feet.
It is time to see your doctor if you experience worsening bone pain along with fever and or chills. If you have an ulcer or had recent surgery or injury, see your doctor right away.
Most osteomyelitis are caused by staphylococcus bacteria, germs commonly found on the skin or in the nose of even healthy people. Germs can enter a bone in a variety of ways, including:
The bloodstream: Germs in other parts of your body can travel through your bloodstream to a weakened spot in a bone and cause infection.
Injuries: Severe puncture wounds can carry germs deep inside your feet. If the injury becomes infected, the germs can spread into a nearby bone. Germs can also enter the body if you have broken a bone that may be sticking out through your skin.
Surgery: It’s very rare but sometimes persons can get germs during surgeries to replace joints or repair fractures.
Bones are very strong and are normally resistant to infection but as you get older this protection gets less. Other factors can make your bones more at risk for osteomyelitis, such as recent injury and circulation problems.
Recent injury: a severe bone fracture or a deep puncture wound gives bacteria a way to enter the bone or nearby tissue. A deep puncture wound, such as an animal bite or a nail piercing through a shoe, can also provide a pathway for infection. Surgery to repair broken bones or replace joints also allow infection to the bone.
Circulation problem: When blood vessels are damaged or blocked, infection-fighting cells cannot get to the area where the infection is. A small cut can progress to a deep ulcer that can cause a bone infection. Acute osteomyelitis can develop within seven to 10 days.
Diseases that impair blood circulation include poorly controlled diabetes, peripheral artery disease, often related to smoking and sickle cell disease.
Prevention and treatment
Reducing your risk of infection will also help your risk of developing osteomyelitis. In general, take precautions to avoid cuts, scrapes and animal scratches or bites, which give germs easy access to your bone. If you or your child has a minor injury, clean the area immediately and apply a clean bandage. Check wounds frequently for signs of infection to prevent osteomyelitis.
Osteomyelitis is most commonly treated by surgery to remove portions of bone that is infected or dead and followed by antibiotics to stop further infection. You may need to stay in the hospital for a while to receive the treatment.
The type of surgery depends on severity of osteomyelitis and some common treatments include:
Draining: Your surgeon will do surgery in the area around the infected bone and drain any pus or fluid that has accumulated due to the infection.
Debridement: The doctor will remove as much dead or diseased bone and tissue as possible. To assure total removal of the infection, a small amount of healthy bone will also be removed. Surrounding tissues that show signs of infection will also be removed.
Restore blood flow: To allow new bones or tissue to grow, the open space left after the debridement will be filled with healthy bone or tissue from another part of your body.
Medications: After surgery, a biopsy of the bone will tell the type of bacterium that has caused the infection. This will determine the type of antibiotic that your doctor will prescribe for you. Normally, antibiotics will be administered through your arm over the course of four to six weeks and then antibiotics in tablets or pills.
Amputation: As a last resort, amputation of the infected leg, foot or toe may be required to stop the infection from spreading to other parts of the body which may cause whole body infection or even death.
• For more information or to see a podiatrist visit Bahamas Foot Centre Rosetta Street, telephone 325-2996 or Bahamas Surgical Associates Centre, Albury Lane, telephone 394-5820 or email firstname.lastname@example.org or visit www.apma.org.