Osteomyelitis

Overview

Osteomyelitis is a bone infection caused by bacteria and fungi. This painful bone infection results in swelling, which can cause swelling and harm bones, leading to bone loss. An infection can spread to a bone through surrounding tissue or the bloodstream, and a wound can make the bone vulnerable to microorganisms.
Osteomyelitis can affect people of all ages and genders, but those over 65, with major medical disorders such as diabetes or kidney failure, and children under 3 are more susceptible. People with foot ulcers due to diabetes are at risk of developing osteomyelitis. There are different types of osteomyelitis:

• Acute: This type has a sudden onset, and patients may experience a fever for a few days before feeling pain in the affected area.
• Chronic: Chronic osteomyelitis does not respond to medical treatment and can results in repeated discharge (pus) and bone pain. In some cases, it can go undiagnosed for months or even years.
• Vertebral: This variety of osteomyelitis affects the spine, and it can result in chronic back pain that exacerbates with movement. Common treatments like rest, heat application, and pain relievers do not provide much relief. Fever rarely accompanies this condition. Spinal bone infections are more likely to occur in people living in nursing homes, misusing intravenous drugs, or undergoing dialysis.

Although osteomyelitis was once considered incurable, it is now effectively treated. Surgical removal of dead bone is necessary in most cases, and strong intravenous antibiotics are typically required after the surgery.

Symptoms

The signs and symptoms of osteomyelitis vary depending on the type and cause. Some patients with chronic osteomyelitis may not exhibit symptoms, or the symptoms may be challenging to distinguish from those of other diseases. Signs and symptoms of osteomyelitis include:

• Fever
• Pus discharge
• Back pain
• Swelling and redness at the infection area.
• Pain at the infection area
• Fatigue or lethargy
• Chills or sweating

Consult a medical professional if the fever and bone discomfort worsen, if symptoms indicate an infection, or if the patient is at risk for infection due to a medical condition, recent surgery, or accident.

Causes

Osteomyelitis develops when germs spread through the blood from surrounding tissue or an open wound and settle in bone, where they multiply. Staphylococcus bacteria, which are commonly found on the skin or in the nose of even healthy individuals, are the primary cause most cases of osteomyelitis cases. The following are ways that the bacteria could enter the bone:

• Bloodstream: Bacteria from other parts of the body, such as those from a urinary tract infection or pneumonia in the lungs, can spread to a weak spot in a bone through the bloodstream. Disease such as sickle cell anemia or blood infection can also cause osteomyelitis.
• Trauma: Bacteria can penetrate deep into the body through severe puncture wounds. If such an injury becomes infected, the infection can spread to an adjacent bone. If the patient has a major bone fracture, and a piece of it protrudes through their skin, bacteria can potentially enter the body. Pressure ulcer or bedsores can also lead to osteomyelitis.
• Surgery: Contaminated surgical procedures can occur during joint replacement or fracture repair surgeries, which can lead to osteomyelitis. Recent bone fractures or bone surgery can also be a cause.

Risk factors

The bones are not commonly affected by infection, but their resistance decreases with age. There are additional factors that can make bones more susceptible to osteomyelitis, such as:

• Injury or bone surgery: Bacteria can infiltrate the bone or surrounding tissue through a severe fracture or a deep wound. Infection can also spread through a deep puncture hole, such as one caused by an animal bite or a nail going through a shoe. Surgery to replace damaged joints or fix broken bones may also create a channel for bacteria to enter the bone, raising the risk of infection, especially with orthopedic hardware implants.
• Intravenous lines or catheters: Medical tubing, such as urinary catheters or dialysis machines, is necessary in many diseases to connect the external environment to internal organs. However, this tubing can also be a route for bacteria to enter the body, increasing the risk of infection in general and the possibility of developing osteomyelitis.
• Circulation problem: When there is damage or blockage to blood vessels, the body may struggle to distribute the necessary infection-fighting cells to prevent a minor infection from becoming more severe. This can result in a small cut progressing into a deep ulcer that exposes deeper tissue and bone to the risk of infection. Other conditions that can impair blood circulation such as uncontrolled diabetes, peripheral artery disease, often caused by smoking, and sickle cell disease.
• Immune system problem: People are at higher risk of developing osteomyelitis if they have a medical condition or are taking medication that weakens their immune system. This can include uncontrolled diabetes or undergoing cancer treatment, which can both compromise the immune system.
• Drug abuse: Those who use illegal drugs through injections are at an increased risk of developing osteomyelitis because of the possibility of using nonsterile needles and a decreased likelihood of sterilizing their skin before injections