What Causes Osteomyelitis?

Osteomyelitis is caused by an infection that has spread to the bone. Many types of bacteria can cause osteomyelitis. The most common form of bacteria is Staphylococcus aureus, which is commonly found on your hands and nose. In many cases, this bacteria may cause minor skin infections. But, if it enters your bloodstream, it can cause serious infections such as osteomyelitis.

Bacteria can enter your body through:

• Open fracture (broken bone where the bone comes through the skin)
• Recent surgery
• Trauma / wound

Risk factors for osteomyelitis in children include:

• Bacterial infection from another part of the body that spreads to the bone
• Delivery complications in newborns
• Diabetes
• Open fractures with damage to surrounding tissue
• Poor blood supply
• Surgery
• Sickle cell disease

What are the Symptoms of Osteomyelitis?

Symptoms of osteomyelitis vary depending on the type and cause. Some common symptoms of osteomyelitis are:

• Fatigue
• Fever
• Pain in a recently injured area
• Redness
• Not wanting to use an arm or leg
• Swelling

How is Osteomyelitis Diagnosed?

Osteomyelitis can only be diagnosed by a doctor. Your doctor will complete a physical exam and review your child’s medical history. They may ask if your child has had any recent colds or infections.

If your doctor suspects your child has osteomyelitis, they may want to do some additional tests such as:

• Blood tests may be done to see if your child has high white blood cells. This is a sign of infection.
• Bone scans use nuclear imaging to look for physical and chemical changes in the bones. Bone scans can find bone abnormalities before an X-ray.
• X-rays use electromagnetic radiation to create pictures of the inside of your body. X-rays may not show an infection in the bone in the early stages.

Types of Osteomyelitis

Osteomyelitis can be broken down into three main categories:

• Acute. An infection that occurs suddenly.
• Subacute. Osteomyelitis symptoms last two to three weeks.
• Chronic. A bone infection that doesn’t go away with treatment. Symptoms may come back for months or years after treatment.

There are also different types of osteomyelitis. They include:

• Acute hematogenous osteomyelitis (AHO) is the most common type of osteomyelitis in children. It occurs when bacteria travel through the bloodstream from another infected area of the body to the bone.
• Direct inoculation osteomyelitis occurs when bacteria enter the body from an open fracture and affect the bone.

The type of osteomyelitis your child has will affect their treatment.

How is Osteomyelitis Treated?

Treatment of osteomyelitis depends on several factors, including:

• Your child’s medical history and health
• Your child’s age
• The type and severity of the infection

The goal of treatment is to control the pain and get rid of the infection. In many cases, treatment includes one or a combination of the following:

Antibiotics can be given through an IV (intravenous line) or by mouth. In some cases, antibiotics may be given through an IV for the first few days and then switched to being taken by mouth.

Pain medication depends on the severity of the pain. Your doctor may prescribe pain medication or recommend over-the-counter medication.

Surgery or another medical procedure may be necessary to clean out the infected area if antibiotics fail or there is an abscess, an area of swelling that contains pus.

What is the Prognosis for Osteomyelitis?

Children with osteomyelitis most often recover well with antibiotics. They do not have long-term effects if osteomyelitis is treated and the infection is cleared up. If the infection is treated properly, osteomyelitis will not come back.

Severe cases of osteomyelitis, which occur when there are abscesses, bone death or slowed bone growth, can cause complications. These include damage to the bone, surrounding tissue, tendons and blood vessels, resulting in chronic infection. In rare cases, amputation of the limb may be needed.

You can reduce your child’s risk of developing osteomyelitis by cleaning all minor injuries with soap and water and covering them with a clean bandage. Check wounds to make sure they are not infected.