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Osteomyelitis

 

Osteomyelitis is a bone infection caused by bacteria or fungi. As such, it causes painful swelling of the bone marrow, the soft tissue that lies inside your child’s bones. If left untreated, the swelling caused by this bone infection can cut off the blood supply to a bone, causing it to die.

If your child needs surgery or casting, our Fracture Care Clinic opens every day and you do not need an appointment. Surgery rooms get scheduled every morning, so your child receives the care and attention they need right away.

Osteomyelitis

Osteomyelitis is a bone infection that can enter the bone via the bloodstream or spread from nearby tissue. Also, infections can begin in the bone if it is injured and exposed to germs. When we see Osteomyelitis, we see the following kinds of patients:

  • Patients who smoke or have chronic health conditions such as diabetes
  • Patients with kidney failure are more likely to develop osteomyelitis.
  • Diabetes patients with foot ulcers are more likely to develop osteomyelitis.

Osteomyelitis, which was once thought as incurable, can now successfully be treated. For many, surgery is required to remove the dead bone. After surgery, strong intravenous antibiotics are usually required.

Bone Infection Causes

  • Recently fractured (broken) a bone
  • Been hurt or have a wound
  • A prosthetic hip or a bone screw
  • Have had recent bone surgery
  • A weakened immune system
  • Previously had osteomyelitis
  • Diabetes
  • A blood infection

Osteomyelitis Symptoms

  • Swelling, warmth, and redness over the infection site.
  • Pain at the infection site.
  • Water drainage (yellow pus).
  • Irritability or sluggishness.
  • Restricted, painful movement
  • Appetite loss.
  • Lower back discomfort.
  • Vomiting and nausea
  • Excessive sweating or chills.

Sometimes, osteomyelitis has no symptoms or the existing symptoms are difficult to distinguish from other problems. For example, this may occur with infants, children, the elderly, and people with weakened immune systems.

Osteomyelitis Causes

The majority of cases of osteomyelitis are caused by staphylococcus bacteria, which are types of germs that are commonly found on the skin or in the noses of even healthy people. When germs enter a bone, they do so through a variety of channels, including:

  • The circulatory system. Germs from other parts of the body, such as pneumonia in the lungs or a urinary tract infection in the bladder, can travel through the bloodstream to a weakened spot in a bone.
  • Injuries. Germs can enter the body through severe puncture wounds. If such an injury becomes infected, the germs can spread to a nearby bone. Also, germs can also enter the body if your child has a broken bone that is protruding through the skin.
  • Surgery. Germ contamination can occur during surgeries to replace joints or repair fractures.

Types of Osteomyelitis

  • Acute: This infection appears unexpectedly. For example, your child may develop a fever followed by pain in the infected area days later.
  • Chronic osteomyelitis: Chronic osteomyelitis is a bone infection that does not respond to treatment. For instance, it causes bone pain and persistent drainage (pus). Chronic osteomyelitis does not always have symptoms. For months or even years, the infection may go undetected.
  • Vertebral: A type of infection that affects the spine. It causes chronic back pain that worsens with movement and treatments such as rest, heating, and pain relievers are ineffective. It almost never causes a fever. For this type of spinal bone infection, people living in nursing homes, abusing intravenous drugs, or are on dialysis are at a higher risk of developing spinal bone infections.

Osteomyelitis Diagnosis

Our Pediatric Orthopedic Specialists may order one or more of the following tests after assessing your child’s symptoms and performing a physical exam:

  • Blood tests:  Tests on the blood: A complete blood count (CBC) detects inflammation and infection. A blood culture examines your bloodstream for bacteria.
  • Imaging tests:  X-rays, MRIs, CT scans, and ultrasounds all produce images of bones, muscles, and tissues.
  • Bone scan:  A bone scan is an imaging scan that uses a small amount of safe, radioactive material to detect infections or fractures.
  • Biopsy:  Needle biopsy is performed by our doctors to obtain samples of fluid, tissue, or bone. It is then examined for signs of infection.

Osteomyelitis Complications

  • Abscesses:  Abscesses can form when an infection spreads to muscles and soft tissue. These pus pockets can seep through skin. Chronic osteomyelitis patients are more likely to develop recurring abscesses. Treatment to drain these abscesses may increase the risk of skin cancer slightly.
  • Bone death:  Also known as osteonecrosis, can occur when infection-related swelling cuts off blood flow to a bone. This may, on rare occasions, result in limb loss or amputation.
  • Osteomyelitis:  Osteomyelitis can slow bone growth in a growing child.
  • Septic arthritis:  Arthritis is caused by bacteria. Infection within bones can sometimes spread to a nearby joint.
  • Arthritis is caused by bacteria:  Infection within bones can sometimes spread to a nearby joint.
  • Growth is hampered:  If osteomyelitis occurs in the softer areas called growth plates at either end of the long bones of the arms and legs, normal bone or joint growth in children can stop.
  • Cancer of the skin:  If your child’s osteomyelitis has caused an open sore that is draining pus, the skin around it is more likely to develop squamous cell cancer.

Conditions that Necessitate the Use of Intravenous Lines or Catheters can Cause Problems

A variety of conditions necessitate the use of medical tubing to connect the outside world to internal organs. This tubing, however, can also serve as a pathway for germs to enter the body, increasing your child’s risk of infection in general, which can lead to osteomyelitis. Examples of applications for this type of tubing include:

  • Tubing for dialysis machines.
  • Urine catheters.
  • Long-term intravenous tubing, also known as central lines.

Immune System Deficiency Conditions

Your child is more likely to develop osteomyelitis if their immune system is compromised by a medical condition or medication. Some of the factors that may suppress an immune system are as follows:

  • Cancer therapy.
  • Uncontrolled diabetes.
  • The need for corticosteroids or tumor necrosis factor inhibitors.
  •  Illicit drugs

Because addicts may use non-sterile needles and are less likely to sterilize their skin before injections, people who inject illegal drugs are more likely to develop osteomyelitis too.

Osteomyelitis Treatment

A bone infection can be difficult to treat. If you begin treatment within three to five days of first noticing symptoms, the infection may clear up faster.  Treatment options include:

  • Antibiotics: Antibiotics are drugs that kill bacteria that cause infections. Our doctors may prescribe antibiotics for four to eight weeks, beginning with intravenous (IV) antibiotics in the hospital for a week or two. Your child will then take medications orally for several weeks. Chronic infections may necessitate months of antibiotic treatment.
  • Antifungals: Your child may need to take antifungal medications orally for months to treat fungal infections.
  • Needle aspiration: A fine needle is used by doctors to drain fluid and pus from the abscess.
  • NSAIDs: Pain and inflammation are treated with nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Surgery: Sometimes our doctors will recommend surgery to treat bone infections. After the surgery, patients will take antibiotics. Surgical alternatives include:
  • Bone surgery: Our doctors may remove infected dead tissue and bone (debrides). 
  • Spine surgery: Children suffering from vertebral osteomyelitis may require spine surgery. This procedure prevents vertebrae from collapsing and damaging the spinal cord, nerves, and other nervous system components.

Osteomyelitis Surgery

If the following occurs to your child, our doctor may recommend surgery:

  • A pus buildup (abscess) develops in the bone; the pus in an abscess must be drained.
  • The infection presses up against something else, such as the spinal cord.
  • The infection has been present for a long time and has caused bone damage.

If the infection has damaged the bone, surgery (known as debridement) may occur to remove the damaged portion. Debridement can leave a gap in the bone that gets filled with antibiotics. To treat an infection, more than one operation may be required. Furthermore, other parts of the body’s muscle and skin near the affected bone may need repair too.

How can I Avoid My Child from Getting Osteomyelitis?

All doctors will tell you to clean and treat wounds to keep bacteria and infections at bay. If your child has had a bone break or surgery, call us at the first sign of infection. Therefore, the earlier we begin treatment, the less chance of osteomyelitis beginning.

Osteomyelitis Prognosis

The majority of patients who get osteomyelitis recover with treatment. The earlier you detect the infection and begin treatment, the better the prognosis. Chronic or untreated infections can permanently damage bones, muscles, and tissues.

When Should your Child See a Doctor?

If your child’s bone pain gets worse and he or she has a fever, you should call to make an appointment with one of our doctors. If your child is at risk of infection or there are signs and symptoms of infection due to a medical condition, recent surgery, or injury, please see one of our doctors as soon as possible.

Prevention:

Finally, if you’ve been told that your child has a higher risk of infection, talk to your doctor about ways to avoid infections. Reducing the risk of infection reduces the chances of developing osteomyelitis. In general, avoid cuts, scrapes, and animal scratches or bites, which allow germs easy access to your child’s body. If you or your child sustains a minor injury, clean the wound right away and apply a clean bandage. In conclusion, inspect wounds for signs of infection on a regular basis and if you are worried about your child’s health, call us for an appointment.

Call 214-556-0590 to make an appointment.

Comprehensive services for children from birth through adolescence at four convenient locations: Arlington, Dallas, Frisco and McKinney.