🦴 Osteomyelitis
Osteomyelitis is a serious infection of the bone, typically caused by bacteria (most commonly Staphylococcus aureus), and less often by fungi or other organisms. It can affect people of any age and can become chronic if not treated promptly.
🧬 Causes
Osteomyelitis can occur through:
- Hematogenous spread (infection via bloodstream)
- Common in children and the elderly
- Often affects long bones (femur, tibia)
- Contiguous spread (from nearby infection)
- From infected wounds, diabetic foot ulcers, or dental infections
- Direct inoculation (trauma or surgery)
- Open fractures, joint replacements, or orthopedic surgery
⚠️ Risk Factors
- Recent bone trauma or surgery
- Diabetes (especially with foot ulcers)
- Poor circulation
- Immune suppression (e.g., HIV, cancer)
- IV drug use
- Use of prosthetic joints or metal implants
🧪 Symptoms
- Localized bone pain
- Swelling, redness, warmth over affected area
- Fever and chills
- Fatigue
- Limited range of motion near the infection
- In chronic cases: draining sinus tract or open wound
🔬 Diagnosis
- Blood tests: Elevated WBC, CRP, ESR
- Blood cultures: Identify the organism
- X-ray: May show changes after 10–14 days
- MRI or CT scan: More sensitive for early diagnosis
- Bone biopsy: Definitive diagnosis; guides antibiotic choice
💊 Treatment
1️⃣ Antibiotics
- Usually IV antibiotics for 4–6 weeks, followed by oral antibiotics
- Based on culture results
- Empiric therapy may begin with vancomycin + a beta-lactam
2️⃣ Surgery
- Debridement: Removal of dead or infected tissue
- Drain abscesses or remove prosthetics if infected
- Bone graft or hardware replacement may be needed
3️⃣ Supportive Care
- Pain management
- Nutritional support
- Wound care (especially in diabetic foot osteomyelitis)
🚨 Complications
- Chronic osteomyelitis
- Sepsis
- Pathological fractures
- Amputation (in severe diabetic or vascular cases)
- Growth disturbances (in children)
🛡️ Prevention
- Proper wound care after trauma or surgery
- Control diabetes and vascular diseases
- Prompt treatment of infections
- Sterile surgical techniques
✅ Key Points
- Osteomyelitis is a serious infection requiring urgent care
- Early diagnosis and aggressive treatment prevent long-term damage
- Chronic cases may require prolonged antibiotics and surgery