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Chronic Osteomyelitis - Symptoms and Treatment
Osteomyelitis is a bacterial infection of bone tissue. Most often, it occurs secondarily from an adjacent soft tissue (skin) site that is infected. It may also be caused by trauma (direct penetration) to a bone, with secondary bacterial contamination. Bone mass may become infected in children secondarily to bacteria growing in the bloodstream (sepsis). Regardless of the cause, osteomyelitis continues to be a serious infection, requiring aggressive, relatively long-term, antibiotic therapy. Common symptoms include: point tenderness to touch over the infected bone; swelling and redness to the skin overlying the site; fever, and chills, are common. Children with lower extremity osteomyelitis may exhibit a limp as the first sign of this problem.
Evaluation will include careful physical examination of the extremity in question. Any history of injury or skin penetration will be important. Bone x-rays will typically not show changes associated with osteomyelitis until the infection has been present for 1-2 weeks. Nuclear bone scanning has proven to be a much more sensitive tool, capable of making a earlier diagnosis. Blood tests (i.e. blood cultures and CBC) will also be important in the management of this infection. Treatment of most cases of osteomyelitis will involve the administration of IV antibiotics in the hospital. Some select cases may require additional surgical debridement (cleansing) of bone infection in the operating room.
Children, diabetics, those with sickle cell anemia, and those with compound bone fractures (bone fragments protruding through the skin, or a laceration overlying the fracture site) are at particular risk for osteomyelitis.
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