Reactivation of osteomyelitis, even after a 50-year disease-free interval, has been reported in the literature (6). In daily clinical practice, these recurrences are not rare and usually occur at the prior anatomical site of infection without any history of concomitant disease, bacteremia, or new trauma.
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.
Infections can reach a bone by traveling through the bloodstream or spreading from nearby tissue. Infections can also begin in the bone itself if an injury exposes the bone to germs. Smokers and people with chronic health conditions, such as diabetes or kidney failure, are more at risk of developing osteomyelitis.
Despite appropriate combined medical and surgical therapies, recurrences are common, often in the range of 20–30%, causing significant morbidity and mortality, as well as major economic losses [7,8,9,10,11].
Summary. Chronic recurrent multifocal osteomyelitis (CRMO) causes abnormal inflammation to occur in and around the bones. Symptoms usually begin in childhood but can occur at any age. Symptoms may include episodes of pain and joint swelling, skin redness, and sometimes a fever.
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.
While some cases of osteomyelitis are of unknown causes, the infection is usually transmitted through the bloodstream from one area of the body to another (Hematogenous osteomyelitis).
Osteomyelitis is a painful bone infection. It usually goes away if treated early with antibiotics. If not, it can cause permanent damage.
Long-term Considerations for Osteomyelitis
Fractures of the affected bone. Stunted growth in children (if the infection has involved the growth plate) Gangrene infection in the affected area.
The goal for treatment of osteomyelitis is to cure the infection and minimize any long-term complications. Osteomyelitis calls for long-term care to prevent complications.
Although osteomyelitis is a difficult problem, certain conditions make it even more difficult to address. Diabetes, peripheral vascular disease, and radiation are all comorbidities that interfere with wound healing and therefore make the treatment of osteomyelitis challenging.
In adults, the vertebrae are the most common site of hematogenous osteomyelitis, but infection may also occur in the long bones, pelvis, and clavicle. Primary hematogenous osteomyelitis is more common in infants and children, usually occurring in the long-bone metaphysis.
The most common treatments for osteomyelitis are surgery to remove portions of bone that are infected or dead, followed by intravenous antibiotics given in the hospital.
Lifestyle changes, such as quitting cigarettes to improve blood circulation. Treatment for underlying cause, such as diabetes. Replacement of the infected prosthetic part, if needed. Surgery to clean and flush out the infected bone (debridement).
In most cases, a bacteria called Staphylococcus aureus, a type of staph bacteria, causes osteomyelitis. Certain chronic conditions like diabetes may increase your risk for osteomyelitis.
Osteomyelitis is a serious condition with a mortality rate of 1 in 5 people if treatment is not started rapidly. There are subtypes of osteomyelitis based on the cause and type of pathogen involved.
The subacute and chronic forms of osteomyelitis usually occur in adults. Generally, these bone infections are secondary to an open wound, most often an open injury to bone and surrounding soft tissue.
In chronic osteomyelitis, IV therapy for 2-6 weeks, followed by oral antibiotics for a total of 4-8 weeks, may be required. Prolonged courses may be required in neonates, immunocompromised or malnourished patients, patients with sickle cell disease, and patients with distant foci of infection (eg, endocarditis).
7, 8 The prevalence of malignant transformation in the setting of chronic osteomyelitis ranges from 1.6% to 23%, and the most commonly affected bones are the tibia and femur. The most frequently observed malignant transformation is squamous cell carcinoma of the skin.
Trimethoprim-sulfamethoxazole was indicated to be successful in the treatment of osteomyelitis in patients with MRSA infected orthopedic implants either alone or in combination with other antibiotics (Sato et al., 2019).
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.
General discomfort, uneasiness, or ill feeling (malaise) Local swelling, redness, and warmth. Open wound that may show pus. Pain at the site of infection.
Open upper extremity fractures with severe soft-tissue damage have the highest risk of developing osteomyelitis.
Reactivation of osteomyelitis, even after a 50-year disease-free interval, has been reported in the literature (6). In daily clinical practice, these recurrences are not rare and usually occur at the prior anatomical site of infection without any history of concomitant disease, bacteremia, or new trauma.