Osteomyelitis is an infection occurring within a bone, potentially affecting various parts of it. The infection can reach the bone via the bloodstream from another infected area in the body or spread from nearby infected tissue. Direct infection can also happen if an injury, like a deep wound or open fracture, exposes the bone to germs. Common symptoms include localized swelling, warmth, and tenderness over the infected area, along with pain and general fatigue or fever. However, sometimes osteomyelitis presents with no obvious symptoms, or the symptoms mimic other conditions, especially in infants, older adults, or those with weakened immune systems.
Causes
The most frequent culprit behind osteomyelitis is Staphylococcus bacteria, germs commonly found on the skin or inside the nose. These germs can gain access to bone tissue in several ways. They might travel through the bloodstream from an infection elsewhere, such as pneumonia or a urinary tract infection, eventually settling in a vulnerable spot in a bone. Penetrating injuries, like puncture wounds or compound fractures where bone breaks through the skin, can introduce germs directly. Surgical procedures, particularly joint replacements or fracture repairs, can also inadvertently allow germs to enter and infect the bone.
Who Is at Higher Risk?
Normally, healthy bones resist infection well, but this ability can decrease with age or due to other factors. Smoking and chronic health issues like diabetes (especially if poorly controlled) or kidney failure significantly elevate the risk. Individuals with diabetes who develop foot ulcers are particularly susceptible to osteomyelitis in the foot bones. Conditions that impair the immune system or circulation, such as peripheral artery disease or sickle cell disease, also increase vulnerability. Medical procedures involving tubing, like dialysis, can provide a pathway for germs. Prolonged pressure leading to skin breakdown (pressure injuries) can allow infection to reach underlying bone. Additionally, illicit intravenous drug use, especially with non-sterile needles, poses a high risk.
Serious Complications of Osteomyelitis
If not treated effectively, osteomyelitis can lead to severe complications. The infection can disrupt blood flow within the bone, causing parts of it to die (osteonecrosis); removing this dead tissue surgically is often necessary for antibiotics to work. The infection might also spread to nearby joints, causing septic arthritis. In children, if osteomyelitis affects the growth plates located at the ends of long bones, it can impair normal bone growth. If the infection proves difficult to eradicate, it can become a long-term, persistent problem known as chronic osteomyelitis, often requiring ongoing management.
Preventing Bone Infections
Individuals at increased risk should discuss preventive measures with their healthcare provider. General precautions are crucial for everyone. Avoid injuries like cuts, scrapes, and animal bites that provide entry points for germs. Promptly and thoroughly clean any minor wounds, apply a clean bandage, and monitor for signs of infection (redness, pus, increased pain). Effectively managing chronic conditions like diabetes is also key to reducing infection risk overall, thereby lowering the chance of developing osteomyelitis.
