Bone Infection (Osteomyelitis)

Medically reviewed by Gregory Minnis, DPT on July 13, 2017Written by Brindles Lee Macon and Matthew Solan

What is a bone infection (osteomyelitis)?

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. In adults, they usually appear in the hips, spine, and feet.

Bone infections can happen suddenly or develop over a long period of time. If they’re not properly treated, bone infections can leave a bone permanently damaged.

What causes osteomyelitis?

Many organisms, most commonly Staphylococcus aureus, travel through the bloodstream and can cause a bone infection. An infection may begin in one area of the body and 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 the site of a hip replacement or bone fracture repair. When your bone breaks, bacteria can invade the bone, leading to osteomyelitis.

The most common cause of bone infections is S. aureus bacteria. These bacteria commonly appear on the skin but don’t always cause health problems. However, the bacteria can overpower an immune system that’s weakened by disease and illness. These bacteria can also cause infections in injured areas.

What are the symptoms?

Usually, the first symptom to appear is pain at the infection site. Other common symptoms are:

How is osteomyelitis diagnosed?

Your doctor may use several methods to diagnose your condition if you have any symptoms of a bone infection. They will perform a physical exam to check for swelling, pain, and discoloration. Your doctor may order lab and diagnostic tests to determine the exact location and extent of the infection.

It’s likely your doctor will order a blood test to check for the organisms causing the infection. Other tests to check for the bacteria are throat swabs, urine cultures, and stool analyses. The stool culture is an example of a stool analysis.

Another possible test is a bone scan, which reveals the cellular and metabolic activity in your bones. It uses a type of radioactive substance to highlight the bone tissue. If the bone scan doesn’t provide enough information, you may need an MRI scan. In some cases, a bone biopsy may be necessary.

However, a simple bone X-ray may be enough for your doctor to determine the treatment that’s right for you.

What are the treatments for osteomyelitis?

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

Antibiotics may be all that’s necessary to cure your bone infection. Your doctor may administer the antibiotics intravenously, or directly into your veins, if the infection is severe. You may need to take the antibiotics for up to six weeks.

Sometimes bone infections require surgery. If you have surgery, your surgeon will remove the infected bone and dead tissue and drain any abscesses, or pockets of pus.

If you have a prosthesis that’s causing the infection, your doctor may remove and replace it with a new one. Your doctor will also remove any dead tissue near or surrounding the infected area.

Who is at risk for osteomyelitis?

There are a few conditions and circumstances that can increase your chances of osteomyelitis, such as:

Can you prevent osteomyelitis?

Thoroughly wash and clean any cuts or open wounds in the skin. If a wound/cut does not look like it is healing with home treatment, contact your doctor immediately to have it examined. 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 treatable. Chronic infections of the bone, however, may take longer to treat and heal, especially if they require surgery. Treatment should be aggressive because an amputation can become necessary sometimes. The outlook for this condition is good if the infection is treated early.

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