Osteomyelitis is a bone infection usually caused by bacteria, including mycobacteria, but is sometimes caused by fungi.
Bacteria or fungi can infect bones by spreading through the bloodstream, spreading from nearby tissue, or directly invading the bone.
People have pain in one part of the bone, fever, and weight loss.
Blood tests and x-rays are done, and doctors remove a sample of bone for tests.
Antibiotics are given for weeks, and surgery may be needed.
Osteomyelitis occurs most commonly in young children and in older people, but all age groups are at risk. Osteomyelitis is also more likely to occur in people with serious medical conditions.
When a bone becomes infected, the soft, inner part (bone marrow) often swells. As the swollen tissue presses against the rigid outer wall of the bone, the blood vessels in the bone marrow may become compressed, which reduces or cuts off the blood supply to the bone. Without an adequate blood supply, parts of the bone may die. These areas of dead bone are difficult to cure of infection because it is difficult for the body's natural infection-fighting cells and antibiotics to reach them. The infection can also spread outward from the bone to form collections of pus (abscesses) in adjacent soft tissues, such as the muscle.
Bacteria or fungi can infect bones by spreading through the bloodstream, spreading from nearby tissue, or directly invading the bone.
People have pain in one part of the bone, fever, and weight loss.
Blood tests and x-rays are done, and doctors remove a sample of bone for tests.
Antibiotics are given for weeks, and surgery may be needed.
Osteomyelitis occurs most commonly in young children and in older people, but all age groups are at risk. Osteomyelitis is also more likely to occur in people with serious medical conditions.
When a bone becomes infected, the soft, inner part (bone marrow) often swells. As the swollen tissue presses against the rigid outer wall of the bone, the blood vessels in the bone marrow may become compressed, which reduces or cuts off the blood supply to the bone. Without an adequate blood supply, parts of the bone may die. These areas of dead bone are difficult to cure of infection because it is difficult for the body's natural infection-fighting cells and antibiotics to reach them. The infection can also spread outward from the bone to form collections of pus (abscesses) in adjacent soft tissues, such as the muscle.
CAUSES
Bones, which usually are well protected from infection, can become infected through three routes:
The bloodstream (which may carry an infection from another part of the body to the bones)
Direct invasion (infection)
Infections in adjacent bone or soft tissues
When organisms that cause osteomyelitis spread through the bloodstream, infection usually occurs in the ends of leg and arm bones in children and in the spine (vertebrae) in adults, particularly in older people. Infections of the vertebrae are referred to as vertebral osteomyelitis. People who undergo kidney dialysis and those who inject drugs using nonsterile needles are particularly susceptible to vertebral osteomyelitis.
Bacteria or fungal spores may infect the bone directly through open fractures, during bone surgery, or from contaminated objects that pierce the bone. Staphylococcus aureus is the bacteria most commonly responsible. Mycobacterium tuberculosis (the main cause of tuberculosis) can infect the vertebrae to cause osteomyelitis
Bones, which usually are well protected from infection, can become infected through three routes:
The bloodstream (which may carry an infection from another part of the body to the bones)
Direct invasion (infection)
Infections in adjacent bone or soft tissues
When organisms that cause osteomyelitis spread through the bloodstream, infection usually occurs in the ends of leg and arm bones in children and in the spine (vertebrae) in adults, particularly in older people. Infections of the vertebrae are referred to as vertebral osteomyelitis. People who undergo kidney dialysis and those who inject drugs using nonsterile needles are particularly susceptible to vertebral osteomyelitis.
Bacteria or fungal spores may infect the bone directly through open fractures, during bone surgery, or from contaminated objects that pierce the bone. Staphylococcus aureus is the bacteria most commonly responsible. Mycobacterium tuberculosis (the main cause of tuberculosis) can infect the vertebrae to cause osteomyelitis
DIAGNOSIS
Symptoms and findings during a physical examination may suggest osteomyelitis. For example, doctors may suspect osteomyelitis in a person who has persistent pain in part of a bone with or without a fever and feels tired much of the time.
Symptoms and findings during a physical examination may suggest osteomyelitis. For example, doctors may suspect osteomyelitis in a person who has persistent pain in part of a bone with or without a fever and feels tired much of the time.
Elevations in the erythrocyte sedimentation rate (ESR—a test that measures the rate at which red blood cells settle to the bottom of a test tube containing blood), and an elevated level of C-reactive protein (a protein that circulates in the blood and dramatically increases in level when there is inflammation) usually occur. Also, blood tests often indicate elevated levels of white blood cells. However, these blood tests are not sufficient to diagnose osteomyelitis
PROGNOSIS AND PREVENTION
Prognosis and Prevention
The prognosis for people with osteomyelitis is usually good with early and proper treatment. However, sometimes, chronic osteomyelitis develops, and a bone abscess may recur weeks to months or years later.
The prognosis for people with osteomyelitis is usually good with early and proper treatment. However, sometimes, chronic osteomyelitis develops, and a bone abscess may recur weeks to months or years later.
TREATMENT
Treatment
For children and adults who have recently developed bone infections through the bloodstream, antibiotics are the most effective treatment. If the bacteria causing the infection cannot be identified, then antibiotics that are effective against Staphylococcus aureus and many types of bacteria (broad-spectrum antibiotics are used. Depending on the severity of the infection, antibiotics may be given by vein (intravenously) for about 4 to 8 weeks but then may be given by mouth later. Some people need months of antibiotic treatment.
For children and adults who have recently developed bone infections through the bloodstream, antibiotics are the most effective treatment. If the bacteria causing the infection cannot be identified, then antibiotics that are effective against Staphylococcus aureus and many types of bacteria (broad-spectrum antibiotics are used. Depending on the severity of the infection, antibiotics may be given by vein (intravenously) for about 4 to 8 weeks but then may be given by mouth later. Some people need months of antibiotic treatment.
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