Osteomyelitis

Osteomyelitis is a bone infection caused by bacteria or fungi. It causes painful swelling of bone marrow, the soft tissue inside your bones. Without treatment, swelling from this bone infection can cut off blood supply to your bone, causing bone to die.

Causes #

• Artificial joint, such as a hip replacement.

• Blood infection or conditions like sickle cell anemia.

• Diabetes, especially a diabetes-related foot ulcer.

• Metal implants in bone, such as a screw.

• Pressure injuries (bedsores).

• Recent broken bone or bone surgery.

• Traumatic injury or wound.

• Weak immune system.

Types #

Types of osteomyelitis include:

Acute #

This infection comes on suddenly. You may have a fever and then develop pain in the infected area days later.

Chronic #

Chronic osteomyelitis is a bone infection that doesn’t go away with treatments. It causes bone pain and recurring drainage (pus). Rarely, chronic osteomyelitis doesn’t have symptoms. The infection may go undetected for months or even years.

Vertebral #

This type affects the spine. It causes chronic back pain that gets worse when you move. Treatments like resting, heating and pain relievers don’t help. It rarely causes a fever. People who live in nursing homes, misuse intravenous drugs or are on dialysis are more prone to spinal bone infections.

Symptoms #

In addition to pain, the infected area may be red, warm, swollen and tender to touch. Other signs of osteomyelitis include:

• Drainage (yellow pus).

• Fever.

• Irritability or lethargy.

• Limited, painful movement.

• Loss of appetite.

• Lower back pain.

• Nausea and vomiting.

• Sweating or chills.

Diagnosis #

Blood tests #

A complete blood count (CBC) checks for signs of inflammation and infection. A blood culture looks for bacteria in your bloodstream.

Imaging tests #

X-rays, MRIs, CT scans and ultrasounds provide images of your bones, muscles and tissues.

Bone scan #

A bone scan uses a small amount of safe, radioactive material to identify infections or fractures during an imaging scan.

Biopsy #

Your healthcare provider performs a needle biopsy to take samples of fluid, tissue or bone to examine for signs of infection.

Treatment #

Antibiotics #

Antibiotics kill infection-causing bacteria. You may need antibiotics for four to eight weeks, starting with intravenous (IV) antibiotics in the hospital for a week or two. You’ll then take medications by mouth for several weeks. Chronic infections may require months of antibiotics.

Antifungals #

To treat fungal infections, you may need to take oral antifungal medications for months.

Needle aspiration #

Your healthcare provider uses a fine needle to drain fluid and pus from the abscess.

Pain relievers #

Nonsteroidal anti-inflammatory drugs (NSAIDs) treat pain and inflammation.

Surgery is sometimes needed to treat bone infections. You’ll need antibiotics after surgery. Surgical options include:

Bone surgery #

Your healthcare provider surgically removes (debrides) infected dead tissue and bone. This procedure may result in bone deformities.

Spine surgery #

People with vertebral osteomyelitis may need spine surgery. This procedure keeps vertebrae from collapsing and damaging your spinal cord, nerves and other parts of your nervous system.