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Osteomyelitis (Bone Infection)

Osteomyelitis is the medical term for a bone infection. Bone infections are caused when a break in the skin allows germs, usually bacteria, to spread into bone tissue. Bacteria can also spread from infections in other parts of the body by traveling through the blood to infect a bone.

Xray image of wrist and arm bones

Causes and risk factors for osteomyelitis

Osteomyelitis can be acute or chronic. Acute osteomyelitis is a new bone infection that develops in about two weeks' time. It's more common in children and more likely to spread into bone through the blood. The most common cause is a bacterium called Staphylococcus aureus.

Chronic osteomyelitis is more likely to occur if there is an open injury near a bone that allows bacteria to spread directly into the bone. This type of infection is more common in adults and can take from one to several months to develop. In chronic osteomyelitis, there may not be enough blood supply to the bone and bone cells may start to die. Many types of bacteria can cause chronic osteomyelitis.

You could be at risk for osteomyelitis if you have any of these injuries:

  • Skin infection or an infection elsewhere in your body

  • Open wound near a bone or a broken bone that breaks the skin

  • Puncture wound through the skin

  • Surgery

Some conditions that may increase your risk of getting osteomyelitis include:

  • Being very young or very old

  • Being a smoker

  • Having a type of disease or condition that lowers your body's ability to fight infections

Symptoms of osteomyelitis

Signs and symptoms that may cause your doctor to suspect osteomyelitis include tenderness over an infected bone, redness and warmth of the skin, drainage of pus from an open wound near a bone, and decreased ability to use the bone for movement and support. Children with acute osteomyelitis are likely to have fever, irritability, and lack of energy.

Diagnosis and treatment of osteomyelitis

Tests that may help your doctor diagnose osteomyelitis include blood tests, wound cultures, X-rays, and bone scans. Blood tests may show signs of infection. Bacteria may be found in about half of all children with acute osteomyelitis. Samples of pus from a wound or from infected bone may show your doctor what type or types of bacteria are causing the infection. Plain X-rays and special types of X-ray studies that create images of bones may also be done.

Once your doctor has diagnosed your type of osteomyelitis and its cause, he or she may treat it with:

  • Antibiotics. Cultures of bone, blood, or pus from a wound will guide your doctor's choice of antibiotic medications. Antibiotics are usually given for four to six weeks. In most cases antibiotics will be given by IV at first. After some time has passed, antibiotic treatment may be switched to pills.

  • Surgery. In chronic osteomyelitis, it may be necessary to surgically open up an area of infection around a bone and remove dead tissue or dead pieces of bone from an infected wound. In some cases, bone may be surgically reconstructed where large pieces of bone have died.

  • Hyperbaric oxygen treatment (HBOT). If you have chronic osteomyelitis and you are not responding to other treatments, or the osteomyelitis involves bones of your spine, skull, or chest, your doctor may order HBOT. This treatment involves staying in a chamber that increases the pressure around your body and allows your lungs to absorb pure oxygen. More oxygen in your blood and tissues helps you fight infection and heal faster. You may need about 100 minutes of this treatment a day for about five weeks for HBOT to be effective.

Preventing osteomyelitis

The best way to prevent osteomyelitis is to prevent skin and wound infections. If you have a minor skin wound, make sure to clean the wound well and cover it with a clean, sterile bandage. Always look for signs of infection such as redness, tenderness, swelling, pain, or discharge. See your doctor if you suspect an infection.

Always get immediate medical care for deep wounds or bone injuries. Let your doctor know if you have a disease or condition that makes it harder for you to fight off infection, and discuss ways to reduce your risk of infection. After treatment of any injury, let your doctor know immediately about any signs of infection.

These are other ways to lower your risk of osteomyelitis:

  • Wash your hands frequently.

  • Keep all your immunizations up-to-date.

  • Don't smoke.

  • Make healthy lifestyle choices.