Osteomyelitis

Osteomyelitis (os-te-o-my-e-LY-tis) is a bone infection that is caused by bacteria. It can involve any bone in the body, but it most commonly affects the long bones in the arms and legs.

The End of Vacation

Kyle stepped on a nail on his first day of vacation at the lake. It punctured the bottom of his foot and hurt pretty badly. His mother cleaned the wound, put antibiotic ointment on it, and watched him for signs of infection. At first he just limped, but then he developed a fever and chills and complained that the bones in his legs hurt. That ended the vacation: Kyle's family packed up and took him home to see his doctor. Blood tests and x-rays showed that Kyle had a bone infection, a condition the doctor called osteomyelitis. Kyle took antibiotics and recovered fully within a month.

What Is Osteomyelitis?

Osteomyelitis is a bone infection that usually is caused by bacteria such as Staphylococcus aureus (staf-i-lo-KOK-us OR-e-us) or Pseudomonas aerugi-nosa (soo-do-MO-nas er-u-ge-NO-sa). Osteomyelitis also may be caused by fungal infections and by tuberculosis, a bacterial infection that most often affects the lungs. An open wound may be the pathway for the bacteria to enter the bloodstream of the body. A very common way that children get it is by stepping on a nail that punctures the shoe and the bottom of the foot. Osteomyelitis-causing fungi and bacteria often live in the soles of gym shoes and can infect the body by contact with wounds on the foot. Other sites of infections may spread into a bone and lead to osteomyelitis. For example, osteomyelitis may occur when a localized infection, such as sinusitis (inflammation of the sinuses in the head), spreads to the nearby bone.

Children get osteomyelitis more often than adults, possibly because children's bones are growing and require more blood circulation (and blood can carry the infection) than the bones of adults. One out of 5,000 children, and twice as many boys as girls, gets osteomyelitis.

What Happens When People Have Osteomyelitis?

The first signs that a person has osteomyelitis are fever, chills, and an overall ill feeling. Tenderness and pain in the infected bone almost always develop, and sometimes the infected area fills with pus. The bone marrow also may become infected.

Osteomyelitis can be either an acute (sudden) or a chronic (long-term) condition. When the bone becomes infected in acute osteomyelitis, the skin that covers the bone usually becomes inflamed and swollen. The condition is diagnosed by a blood culture, by a biopsy (tissue sample), or by an x-ray or bone scan examination. If acute osteomyelitis is confirmed, antibiotic treatment begins immediately, often with an excellent chance of complete recovery.

When osteomyelitis is not treated, or does not respond to treatment, it may become a chronic, or long-term, condition. In its chronic stages, osteomyelitis can be very painful and cause considerable damage to the infected bones. Sometimes this chronic form develops from compound fractures (more than one break in a bone). Antibiotics are used to treat chronic osteomyelitis, but sometimes surgery also is required to remove infected areas of bone.

In rare cases, the lung infection caused by tuberculosis can spread to bones (especially the spine), causing a form of osteomyelitis. When tuberculosis is involved, drugs to combat tuberculosis are used to treat both conditions.

Good hygiene is the best prevention for osteomyelitis. Proper treatment of all breaks in the skin is an important first step in preventing this bone infection. In the United States and other developed countries, osteomyelitis is an uncommon disease. When osteomyelitis does occur, it usually can be treated successfully.