Osteomyelitis

Description of Osteomyelitis

Osteomyelitis is an infectious inflammation of the bone or bone marrow, when microbes enter from the outside (trauma-induced wound, open bone fracture, deep burn, bone surgeries) or travel through the blood from other infectious foci. The most common causative agents of the disease are Staphylococcus aureus, E. coli. Less frequently, hemolytic streptococci and others.

Depending on the course of the disease, osteomyelitis is classified as acute or chronic. According to the cause of the disease, it is divided into post-traumatic, hematogenous, postoperative, specific (syphilis, cancer, tuberculosis), and special forms (Brodie abscess).

Risk factors influencing the development of the disease include poor nutrition and immune status, diabetes, alcoholism, and blood circulation disorders.

Symptoms

Manifestations include local swelling, pain, redness, local muscle tension, inability to bear weight on the affected limb. Laboratory blood tests show increased inflammatory markers – leukocytosis, ESR, CRP.

Diagnosis

The diagnosis is based on medical history, symptoms, blood tests showing elevated inflammatory markers, microscopy of punctate (material taken from the lesion), bacterial culture growth, X-ray/CT scans, radioisotope scanning, fistulography.

Treatment

In the case of acute hematogenous osteomyelitis, bone perforation is performed, abscesses are drained, antibiotics are prescribed, fluids are administered intravenously, anticoagulants are given. In chronic osteomyelitis, sequestrectomy (removal of the affected bone), radical excision of infected bone/soft tissues, antibiotics, oxygenation, and plastic surgery with vascularized skin-muscle flap are performed.

Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology