What is it?

It's a bone infection. It is mainly caused by bacteria or other germs. Bacteria or other microorganisms can spread to bone from infected skin, muscles, or tendons near the bone. This can happen under a skin ulcer. The infection can also start in another part of the body and spread to the bone through the blood, or after bone surgery. This is more likely if the intervention is done after an injury or if rods or metal plates are placed in the bone.

In children, the long bones of the arms or legs are almost always involved. In adults, the bones of the feet, spine (vertebrae), and hips (pelvis) are most commonly affected.

Osteomyelitis is a sudden or long-term infection of the bone or bone marrow, usually caused by pyogenic bacteria or mycobacteria and fungi. Risk factors include recent trauma, diabetes, hemodialysis, and intravenous drug abuse.

Patients with acute osteomyelitis of peripheral bones usually have weight loss, tiredness, fever and heat, swelling, erythema and localized pain.

Vertebral osteomyelitis produces localized back pain and compression pain with paravertebral muscle spasm that does not respond to conservative treatment. More advanced disease may cause compression of the spinal cord or nerve roots, with root pain and weakness or numbness of the extremities. Often the patient does not have a fever.

Chronic osteomyelitis produces intermittent bone pain (months to years), pain at compression, and sinuses drainage.

Effective antibiotics against gram-positive and gram-negative microorganisms are given until the results of the culture and the antibiogram are obtained.

If general signs persist (fever, malaise, weight loss) or if there is destruction of large areas of bone, surgical debridement of the necrotic bone should be performed. Surgery may be necessary to drain coexisting paravertebral or epidural abscesses or to stabilize the spine and prevent injury. Skin or pedicle grafts are used to cover extensive surgical defects. Broad-spectrum antibiotics should be continued for more than 3 weeks after surgery. Prolonged antibiotic treatment may be necessary.