- Main causes
- How to identify
- How the treatment is done
- When is amputation necessary?
- Other treatments
Osteomyelitis is the name given to bone infection, usually caused by bacteria, but which can also be caused by fungi or viruses. This infection happens either through direct contamination of the bone, through a deep cut, a fracture or implant of a prosthesis, but it can also reach the bone through the bloodstream, during the course of an infectious disease, such as an abscess, endocarditis or tuberculosis., for example.
Anyone can develop this infection, which is not usually contagious from one person to another, and the symptoms caused include localized pain in the affected region, swelling and redness, as well as fever, nausea and tiredness. In addition, osteomyelitis can be classified according to the time of evolution, mechanism of infection and response of the organism:
- Acute: when it is diagnosed in the first 2 weeks of the disease; Sub-acute: it is identified and diagnosed within 6 weeks; Chronic: it happens when it lasts more than 6 weeks or when it forms an abscess, usually because it is not identified and treated soon, evolving and worsening slowly and continuously, which can persist for months or even years.
Osteomyelitis has a difficult and time-consuming treatment, including the use of drugs to eliminate microorganisms, such as antibiotics with high doses and for a long time. Surgery can also be indicated in more severe cases, to remove dead tissue and facilitate recovery.
Main causes
Some of the main factors associated with the development of osteomyelitis are:
- Skin or dental abscesses; Skin lesions such as cuts, wounds, infectious cellulitis, injections, surgery or device implantation; Bone fracture, in accidents; Joint or bone prosthesis implantation; Generalized infections, such as endocarditis, tuberculosis, brucellosis, aspergillosis or candidiasis.
Osteomyelitis can occur in anyone, including adults and children. However, people with compromised immunity, such as those with decompensated diabetes, who use corticosteroids chronically or who undergo chemotherapy, for example, as well as people who have impaired blood circulation, who have neurological diseases or who have recently undergone surgery greater risk to develop this type of infection more easily, as these are situations that compromise the healthy blood flow to the bone and favor the proliferation of microorganisms.
How to identify
The main symptoms of osteomyelitis, both acute and chronic, include:
- Local pain, which can be persistent in the chronic phase; Swelling, redness and heat in the affected area; Fever, from 38 to 39ºC; Chills; Nausea or vomiting; Difficulty moving the affected region; Abscess or skin fistula.
The diagnosis is made through clinical examination and complementary tests and laboratory tests (blood count, ESR, PCR), as well as radiography, tomography, magnetic resonance or bone scintigraphy. A piece of the infected material must also be removed to identify the microorganism responsible for the infection, facilitating treatment.
The doctor will also take care to differentiate osteomyelitis from other diseases that can cause similar symptoms, such as septic arthritis, Ewing's tumor, cellulitis or deep abscess, for example. Check out how to differentiate the main causes of bone pain.
How the treatment is done
In the presence of osteomyelitis, treatment needs to be carried out as soon as possible to allow healing, with potent medications that have a quick effect, guided by the orthopedist. It is necessary to remain in the hospital to start antibiotics in the vein, perform tests to identify the microorganism and even surgery.
If there is clinical improvement with the medications, it is possible to continue the treatment at home, with medications orally.
When is amputation necessary?
Amputation is only necessary as a last resort, when bone involvement is very severe and has not improved with clinical treatment or surgery, presenting a high risk of life for the person.
Other treatments
No type of home treatment should replace medications directed by the doctor to treat osteomyelitis, but a good way to speed recovery is to rest, and maintain a balanced diet with good hydration.
Physiotherapy is not a treatment that helps cure osteomyelitis, but it can be useful during or after treatment to maintain quality of life and help recovery.
