Bone Infections (Osteomyelitis)
Bacterial infections of the bone (osteomyelitis) require IV antibiotics because the oral ingestion of antibiotics produces inadequate concentrations of the drug in the bone. The most common length of treatment is 6 weeks. However, certain prosthesis infections (hardware) or debilitated patients may require much longer treatment.
Bone infections are most often caused by staphylococcus bacteria, but they can also be caused a myriad of other bacteria colonizing the Gastrointestinal and Genitourinary (genital and/or urinary) Tract.
Bacteria can spread to a bone from infected skin, muscles, or tendons in close proximity to the bone.
The infection can spread to the bone through the blood.
Infection can be difficult to eradicate following surgery, particularly when screws, plates, and other prosthetic devices are installed in the bone.
Symptoms of Bone Infections
The signs of osteomyelitis include bone pain, fever, chills, swelling, redness, and pain at the infection site. Patients may also notice swelling in the lower extremities. More commonly, patients will lack an appetite and have general lethargy.
Along with the symptoms listed above, clinical tests that include blood cultures, bone biopsies, scans, x-rays, magnetic resonance imaging (MRI), and needle aspiration can be conducted to determine if osteomyelitis is present.
Bone Infection Treatment
Resolving osteomyelitis is usually accomplished with IV antibiotics. Some cases may require surgical excision if bone to complement the medical treatment. If persistence beyond medicine and surgery occurs, HBOT is recommended and may be beneficial. If the infection is attributed to the installation of hardware, that hardware may need to be removed in order to heal fully though certain patients can avoid surgical removal but may need to remain on
long-term oral antibiotic suppression.
Refractory osteomyelitis is a persistent or recurrent bone infection despite appropriate surgical and medical therapy, such as debridement and intravenous antibiotics. In some individuals, conditions are worse when co-morbidities like vascular disease or diabetes is present. Treatments can include a course of IV antibiotics, hyperbaric oxygen therapy or both.
Watch the short video below to understand a little more about a patient who has refractory osteomyelitis.