Osteomyelitis is an inflammation of the bone marrow and surrounding bone due to an infection. When a bone gets infected, the bone marrow (the soft part inside the bone) swells and presses against the bone’s blood vessels. The bone cells can’t get enough blood and parts of the bone may die. The infection can spread to the surrounding muscles and other soft tissues, causing pus to collect in the area. This is known as an abscess.
A bone infection is usually caused by bacteria, but sometimes other organisms such as a fungus may be the cause. The most common bacterial cause of osteomyelitis is Staphylococcus aureus. Other bacterial causes include Streptococcus group A and group B, H. influenzae, coliforms, and Pseudomonas aeruginosa, all of which can be associated with longstanding open skin ulcers that penetrate deep into the bone or with a traumatic injury that penetrates down to the bone. Bones are usually well protected and don’t become infected easily.
Bone infection can occur if:
An infection can spread into the bone in many ways. It can enter during bone surgery or through a broken bone that protrudes through the skin. It can also spread from an infected artificial joint, such as a knee joint, into the surrounding bone. Any contaminated object that pierces the bone, such as a piece of metal from a car accident, can cause an infection.
Infection in soft tissue, such as muscles or organs, can develop in an area that has been injured or has poor blood circulation. Once the infection appears, it can then spread to the nearby bone.
Children may develop bone infections in their arms and legs from an infection carried from another part of the body through the blood. Adults tend to develop infections in the bones of their spine (spinal vertebrae) through this route.
If you’ve had orthopedic surgery, such as hip replacement or knee replacement, where a piece of metal was attached to a bone, an infection can develop. The infection may occur early after surgery if bacteria from the surface of the skin contaminated the artificial hip or knee. The infection may occur years later if bacteria enter the bloodstream and are carried to the artificial hip or knee.
People who take illicit drugs by injection and people on kidney dialysis are at higher risk for developing osteomyelitis due to the higher risk of bloodstream infections in these groups.
The bacteria responsible for tuberculosis can also infect the bones in a rare condition called Pott’s disease.
Treatment of osteomyelitis depends on how the infection has spread to the bone and how deeply it has penetrated. If the bone infection has come through the blood and is a recent infection, treatment with oral antibiotic medications in high doses usually works. You’ll be prescribed antibiotics against Staphylococcus aureus and many types of bacteria (broad-spectrum antibiotics) unless your doctor has identified another type of bacteria responsible for the infection.
Because bacteria are increasingly resistant to commonly used antibiotics, your doctor may take a sample from the infection to create a culture (letting the bacteria from the infection grow in the lab). This is essential in choosing the antibiotic most likely to work.
If a fungal infection is suspected as the cause for the osteomyelitis, then an antifungal medication may be prescribed.
If the osteomyelitis is very severe, you might need to take intravenous antibiotics at first and then switch to oral antibiotic pills later, once the infection is under control. People usually take them for 4 to 6 weeks, except for recurrent infections or infections of the spinal vertebrae, which need a 6- to 8-week treatment.
For serious infections, the buildup of pus may need to be drained by surgery. If the infection has spread from surrounding soft tissue, the dead tissue and bone is removed by surgery, and the space is filled with healthy bone, muscle, or skin by grafting before antibiotics are given.
If an artificial joint is infected, it has to be surgically removed and replaced. Antibiotics are usually given before and after surgery. In rare cases, the infection may not be cured and the infected limb may need to be amputated or the joint fused with surgery.
Sometimes foot ulcers (infections caused by poor circulation) due to diabetes can spread to the bones of the feet. These infections are often difficult to cure with antibiotics alone, and sometimes the infected bone must be surgically removed. This is one of the reasons people with diabetes should learn to take care of their feet and follow their diet and treatment plan to get their blood sugar within normal ranges. Ulcers and osteomyelitis may not heal if diabetes is not controlled, which can lead to amputations
Wound care after surgery is incredibly important. Infectious disease specialists may monitor the healing process and adjust therapy if needed. People who continue antibiotic therapy at home are encouraged to use wound care clinics if available.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
All material copyright MediResource Inc. 1996 – 2025. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Osteomyelitis
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