What is Osteomyelitis?
Osteomyelitis was once a major cause of death in children. Since the advent of antibiotics, the complications of osteomyelitis have significantly decreased.
Osteomyelitis is infection of the bone. It is most commonly seen in children and people who are immunocompromised. It is thought that bacteria enter the blood from a concurrent infection like a chest infection, or from little cuts in the mouth when we are eating food. Most of the time the body’s immune system fights off these isolated bacteria. Occasionally the bacteria find refuge in areas that are relatively free of the normal immune system. In growing bones this is around the growth plate of the bone. Here the bacteria take hold and wall themselves off from the body’s immune system.
Symptoms and Diagnosis
In adults osteomyelitis may arise from trauma with open fractures. It can also occur in people who inject drugs, or who have severe infections spreading to the bone.
The body in turn walls off the infection much like an abscess, but in the bone this is made out of hard bone, and can sometimes be seen on X-rays. If the infection continues to grow, it will lead to an increased pressure within the bone and compromise the blood supply to parts of the bone leading to dead bone been present inside the bone, with ongoing infection the pressure will build and create a hole in the bone and eventually develop a tract through the soft tissues to the skin developing a draining sinus. Fortunately these are rarely seen today, thanks largely to antibiotic treatment.
Occasionally the body will wall of the bacteria, and they will remain there for many years until such stage that the body’s immune system breaks down and the bacteria overcome the normal defenses against the spreading infection.
In some cases, strong and targeted antibiotic treatment may be effective in combating osteomyelitis. If the bone diseases has advanced too far, it may be necessary to excise the affected area, or amputate the limb in question.
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