Bone Infection (Osteomyelitis)

Written by Brindles Lee Macon and Matthew Solan | Published on August 15, 2012
Medically Reviewed by George Krucik, MD

Overview

A bone infection, also called osteomyelitis, can result when bacteria or fungi invade a bone.

In children, bone infections most commonly occur in the long bones of the arms and legs, but in adults they usually appear in the hips, spine, and feet.

Bone infections may come on suddenly or develop over a long period of time. If not properly treated, bone infections can leave the bone permanently damaged.

What Causes a Bone Infection (Osteomyelitis)?

Bone infections are more often caused by the staphylococcus aureus bacteria than any other organism. These bacteria are commonly found on the skin but do not always cause health problems. However, it can overpower an immune system weakened by disease and illness. These bacteria can also cause infections in areas of injury.

 

Many organisms—most commonly staphylococcus—travel through the bloodstream and can cause a bone infection. An infection may begin in one area of the body but spread to the bones via the blood stream.

 

Organisms that invade a severe injury, deep cut, or wound can also cause infections in nearby bones. Bacteria can enter your system at a surgical site, such as for a hip replacement or bone fracture repair. When a bone is broken in an accident, bacteria can invade the bone leading to osteomyelitis.

What are the Risks Of Osteomyelitis?

There are a few conditions and circumstances that can increase your chances of osteomyelitis. Such as

  • diabetic disorders that affect blood supply to the bones.
  • intravenous use of drugs.
  • use of hemodialysis, a treatment used for kidney conditions.
  • trauma to the tissue surrounding the bone.
  • prosthesis or artificial limbs that introduce bacteria.

What are the Symptoms?

Usually, the first symptom to appear is pain in the location of the infection. Others common signs are:

  • fever and chills
  • redness over the infected area
  • irritability or generally feeling unwell
  • drainage from the area
  • swelling in the affected area—the feet, for example, may fill with fluid
  • stiffness or loss of use of an affected limb

How is Osteomyelitis Diagnosed?

If you have any symptoms of a bone infection your physician may use several methods to diagnose your condition. A physical exam is required to check for swelling, pain, and discoloration in the location of your complaint. Your doctor may order lab and diagnostic tests to determine the exact location and extent of the infection.

It is likely your doctor will order a blood test to check for the organisms causing the infection. Other tests to check for the bacteria are urine, fecal, and throat swabs.

A bone scan is diagnostic method that reveals cellular and metabolic activity in the bones. It uses a type of radioactive substance to highlight the bone tissue. If the bone scan does not provide enough information, you may need an MRI (magnetic resonance imaging). In some cases, a bone biopsy may even be necessary.

However, a simple bone X-ray may prove sufficient for your doctor to determine your plan of treatment.

What are the Treatments for Osteomyelitis?

There are several treatment options your doctor may use to treat your bone infection.

Antibiotics may be all that are needed to cure your bone infection. If the infection is severe, the antibiotics may be administered directly into the veins (“intravenously”) rather than by mouth. You may need to take the antibiotics for up to six weeks.

Surgery is an option for bone infections that do not clear up with antibiotics. Your physician would remove the infected bone and dead tissue. Infections that produced pockets of pus (abscesses) would be drained.

If you have a prosthesis that caused the infection, your doctor may remove and replace it with a new one. Any dead tissue near or surrounding the infected area would need to be surgically removed.

Can You Prevent Osteomyelitis?

Thoroughly wash or clean any cuts or open wounds in the skin. Report any wounds or cuts that do not heal to your physician. Clean and dry amputation sites before placing your prosthesis. Also, use the proper footwear and protective equipment to avoid injuries when jumping, running or participating in sports.

What is the Long-Term Outlook?

Most cases of osteomyelitis are easily treatable. Chronic infections of the bone, however, may take longer to treat and heal, especially if they require surgery. The prognosis for this condition is good when the infection is found and treated early.

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