Osteomyelitis
My
Story
Overview
Osteomyelitis is
an infection in a bone. Infections can reach a bone by traveling through the
bloodstream or spreading from nearby tissue. Infections can also begin in the
bone itself if an injury exposes the bone to germs.
Smokers and people with
chronic health conditions, such as diabetes or kidney failure, are more at risk
of developing osteomyelitis. People who have diabetes may develop osteomyelitis
in their feet if they have foot ulcers.
Although once considered
incurable, osteomyelitis can now be successfully treated. Most people need
surgery to remove areas of the bone that have died. After surgery, strong
intravenous antibiotics are typically needed.
Symptoms
Signs and symptoms of
osteomyelitis include:
Fever
Swelling, warmth and redness
over the area of the infection
Pain in the infection
Fatigue
Sometimes osteomyelitis
causes no signs or symptoms, or the signs and symptoms are hard to distinguish
from other problems. This may be especially true for infants, older adults, and
people whose immune systems are compromised.
When to see a doctor
See your doctor if you
experience worsening bone pain along with fever. If you are at risk of
infection because of a medical condition or recent surgery or injury, see your
doctor right away if you notice signs and symptoms of an infection.
Causes
Most cases of osteomyelitis
are caused by staphylococcus bacteria, types of germs commonly found on the
skin or in the nose of even healthy individuals.
Germs can enter a bone in a
variety of ways, including:
The bloodstream.
Germs in other parts of your body — for example, in the lungs from pneumonia or
in the bladder from a urinary tract infection — can travel through your
bloodstream to a weakened spot in a bone.
Injuries. Severe puncture
wounds can carry germs deep inside your body. If such an injury becomes infected,
the germs can spread into a nearby bone. Germs can also enter the body if you
have broken a bone so severely that part of it is sticking out through your
skin.
Surgery.
Direct contamination with germs can occur during surgeries to replace joints or
repair fractures.
Risk factors
Your bones are normally
resistant to infection, but this protection lessens as you get older. Other
factors that can make your bones more vulnerable to osteomyelitis may include:
Recent injury or
orthopedic surgery
A severe bone fracture or a
deep puncture wound gives bacteria a route to enter your bone or nearby tissue.
A deep puncture wound, such as an animal bite or a nail piercing through a
shoe, can also provide a pathway for infection.
Surgery to repair broken
bones or replace worn joints also can accidentally open a path for germs to
enter a bone. Implanted orthopedic hardware is a risk factor for infection.
Circulation disorders
When blood vessels are
damaged or blocked, your body has trouble distributing the infection-fighting
cells needed to keep a small infection from growing larger. What begins as a
small cut can progress to a deep ulcer that may expose deep tissue and bone to
infection.
Diseases that impair blood
circulation include:
Poorly controlled diabetes
Peripheral artery disease,
often related to smoking
Sickle cell disease
Problems requiring
intravenous lines or catheters
There are a number of
conditions that require the use of medical tubing to connect the outside world
with your internal organs. However, this tubing can also serve as a way for
germs to get into your body, increasing your risk of an infection in general,
which can lead to osteomyelitis.
Examples of when this type
of tubing might be used include:
Dialysis machine tubing
Urinary catheters
Long-term intravenous
tubing, sometimes called central lines
Conditions that
impair the immune system
If your immune system is
affected by a medical condition or medication, you have a greater risk of
osteomyelitis. Factors that may suppress your immune system include:
Cancer treatment
Poorly controlled diabetes
Needing to take
corticosteroids or drugs called tumor necrosis factor inhibitors
Illicit drugs
People who inject illegal
drugs are more likely to develop osteomyelitis because they may use nonsterile
needles and are less likely to sterilize their skin before injections.
Complications
Osteomyelitis complications
may include:
Bone death (osteonecrosis).
An infection in your bone can impede blood circulation within the bone, leading
to bone death. Areas where bone has died need to be surgically removed for
antibiotics to be effective.
Septic arthritis.
Sometimes, infection within bones can spread into a nearby joint.
Impaired growth.
Normal growth in bones or joints in children may be affected if osteomyelitis
occurs in the softer areas, called growth plates, at either end of the long
bones of the arms and legs.
Skin cancer. If
your osteomyelitis has resulted in an open sore that is draining pus, the
surrounding skin is at higher risk of developing squamous cell cancer.
Prevention
If you have been told that
you have an increased risk of infection, talk to your doctor about ways to
prevent infections from occurring. Reducing your risk of infection will also minimize
your risk of developing osteomyelitis.
In general, take precautions
to avoid cuts, scrapes and animal scratches or bites, which give germs easy
access to your body. If you or your child has a minor injury, clean the area
immediately and apply a clean bandage. Check wounds frequently for signs of
infection.
In 1948 I was 18 months old and
developed a case of Osteomyelitis in my right leg and was admitted to the
nearest hospital in Franklin, Virginia.
As young as I was, I remember the event like it was yesterday. My mother and grandmother were hovering about,
and an orthopedic surgeon would appear from time to time and give my mother an
update. I remember he never spoke to me
once. My right let was in a sling pulled
high above me and we learned I was allergic to Sulfa drugs. Medicine, in general, was primitive in 1948
but my right leg survived and at age 75 I run on a treadmill overnight before
bedtime. I will never forget that
orthopedic surgeon telling my mother I may have to lose my right leg. You know how the expression goes, “Surgeons are
not always right, and they are not always wrong, but they are always sure.”
Jan Ricks Jennings, MHA,
LFACHE
Senior Consultant
Senior Management
Resources, LLC
JanJenningsBlog.Blogspot.com
412.913.0636 Cell
724.733.0509 Office
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