Osteomyelitis

DEFINITION

Osteomyelitis is an infection in a bone. Infections can reach a bone by traveling through the bloodstream or spreading from nearby tissue. Osteomyelitis can also begin in the bone itself if an injury exposes the bone to germs.

In children, osteomyelitis most commonly affects the long bones of the legs and upper arm, while adults are more likely to develop osteomyelitis in the bones that make up the spine (vertebrae). People who have diabetes may develop osteomyelitis in their feet if they have foot ulcers.

Once considered an incurable condition, osteomyelitis can be successfully treated today. Most people require surgery to remove parts of the bone that have died — followed by strong antibiotics, often delivered intravenously, typically for at least six weeks.

CAUSES

Most cases of osteomyelitis are caused by staphylococcus bacteria, a type of germ commonly found on the skin or in the nose of even healthy individuals.

Germs can enter a bone in a variety of ways, including:

• Via the bloodstream. Germs in other parts of your body — for example, from pneumonia or a urinary tract infection — can travel through your bloodstream to a weakened spot in a bone. In children, osteomyelitis most commonly occurs in the softer areas, called growth plates, at either end of the long bones of the arms and legs.
• From a nearby infection. Severe puncture wounds can carry germs deep inside your body. If such an injury becomes infected, the germs can spread into a nearby bone.
• Direct contamination. This may occur if you have broken a bone so severely that part of it is sticking out through your skin. Direct contamination can also occur during surgeries to replace joints or repair fractures.

SYMPTOMS

Signs and symptoms of osteomyelitis include:

• Fever or chills
• Irritability or lethargy in young children
• Pain in the area of the infection
• Swelling, warmth and redness over the area of the infection

Sometimes osteomyelitis causes no signs and symptoms or has signs and symptoms that are difficult to distinguish from other problems.

When to see a doctor

See your doctor if you experience worsening bone pain along with fever. If you’re at risk of infection because of a medical condition or recent surgery or injury, see your doctor right away if you notice signs and symptoms of an infection.