Acute osteomyelitis develops rapidly over a period of seven to 10 days.
The infection spreads to the bone after several days or weeks. This type of spread is particularly likely to occur in older people. Such an infection may start in an area damaged by an injury or surgery, radiation therapy, or cancer or in a skin ulcer (particularly a foot ulcer) caused by poor circulation or diabetes.
Osteomyelitis is a serious condition that requires immediate treatment. Most bone infections go away when you take antibiotics. Be sure to take all your prescribed medication even if you start feeling better. Stopping medications too soon can allow the infection to return.
Acute osteomyelitis typically refers to an infection of less than 1 month's duration, whereas chronic osteomyelitis refers to infection that lasts longer than 4 weeks.
Chronic osteomyelitis presents 6 weeks or longer after a bone infection, and its characteristics include bone destruction and formation of sequestra. Leading complications resulting from chronic osteomyelitis include sinus tracts and extension to adjacent structures, as well as abscess formation.
Osteomyelitis can have a sudden onset, a slow and mild onset or may be a chronic problem, depending on the source of the infection.
It characterizes osteomyelitis as being in one of four anatomic stages. In stage 1, or medullary, osteomyelitis is confined to the medullary cavity of the bone. Stage 2, or superficial, osteomyelitis involves only the cortical bone and most often originates from a direct inoculation or a contiguous focus infection.
The crude mortality rate of osteomyelitis associated with diabetes increased with age (<55 years: 0.50, 95% CI: 0.48–0.52; 55 to 64 years: 5.49, 95% CI: 5.30–5.67; 65 to 74 years: 11.77, 95% CI: 11.44–12.10; 75 to 84 years: 21.82, 95% CI: 21.25–22.40; and 85+ years: 36.86, 95% CI: 35.67–38.05).
In adults, osteomyelitis most often affects the vertebrae of the spine and/or the hips. However, extremities are frequently involved due to skin wounds, trauma and surgeries.
With treatment, the outcome for acute osteomyelitis is often good. The outlook is worse for those with long-term (chronic) osteomyelitis. Symptoms may come and go for years, even with surgery. Amputation may be needed, especially in people with diabetes or poor blood circulation.
Some of the complications of osteomyelitis include: Bone abscess (pocket of pus) Bone necrosis (bone death) Spread of infection.
Osteomyelitis can be a short- or long-term problem. It is treated with antibiotics. You will probably get treatment in the hospital first with antibiotics through a needle in a vein (IV) and then take antibiotic pills.
The duration of therapy for acute osteomyelitis is 4-8 weeks. The optimal duration of therapy for chronic osteomyelitis is uncertain, but treatment is usually administered for a minimum of 6 weeks.
Traditionally, antibiotic treatment of osteomyelitis has consisted of a 4- to 6-week course. Animal studies and observations show that bone revascularization following debridement takes about 4 weeks. However, if all infected bone is removed, as in forefoot osteomyelitis, antibiotic therapy can be shortened to 10 days.
Osteomyelitis complications may include: Bone death (osteonecrosis). An infection in your bone can impede blood circulation within the bone, leading to bone death. Areas where bone has died need to be surgically removed for antibiotics to be effective.
Osteomyelitis is most common in young kids under age 5. But it can happen at any age. Boys get it almost twice as often as girls do. Some children have a higher risk of developing osteomyelitis, such as those with a weak immune system or chronic conditions like sickle cell disease.
Osteomyelitis is very serious and if left untreated, can lead to necrosis or cell death. If necrosis is left untreated, it can lead to sepsis, which is infection in the blood. Sepsis can lead to multiple organ failure and eventually death.
The hallmark of chronic osteomyelitis is the presence of dead bone (sequestrum). Other common features of chronic osteomyelitis include involucrum (reactive bony encasement of the sequestrum), local bone loss, and, if there is extension through cortical bone, sinus tracts.
Bone culture remains the reference standard for the microbiological diagnosis of osteomyelitis; consecutive deep sinus tract cultures may be used when a biopsy cannot be performed [28]. 8.
It is a progressive inflammatory process caused by pathogens, resulting in bone destruction and sequestrum formation. The infection can be limited to the bone, or it can propagate to the bone marrow, the periosteum and the surrounding soft tissues.
Many bone infections are cleared with medication, surgery, or a combination of the two. However, for some people, osteomyelitis may never completely go away.
The gold standard for the diagnosis of osteomyelitis is bone biopsy with histopathologic examination and tissue culture.
Staphylococcus aureus is the most common cause of acute and chronic hematogenous osteomyelitis in adults and children. [1][5] Increasingly isolated from patients with osteomyelitis is methicillin-resistant Staphylococcus aureus (MRSA). In some studies, MRSA accounted for over one-third of all staphylococcal isolates.