Osteomyelitis is the infection of the bone caused by bacteria or fungal elements. Bone infection happens when bacteria is introduced through an opening in the foot (ulcers) or through the bloodstream (most common in children). If left untreated bone infection can lead to sepsis, infection, amputations and death.
Osteomyelitis (Bone Infection)
Causes:
PAD- Arterial disease causes poor circulation and decreases the ability of the body to heal the infected bone
Diabetes- Elevated blood sugar causes skin to get stiff and more prone to breakdown. This opening allows for bacteria to infect the bone.
Sepsis- Infection with bacteria in the blood can allow the bacteria to seed into the bone.
Neuropathy- Decreased sensation in the foot can lead to opening in the foot and ankle. This allows an opening for the bacteria to inject the healthy bone
Weakened Immune System- Decreases the body’s own ability to fight the infection
IV Drug Abuse- The IV use allows for a portal of entry for the bacteria to seed into the bone
Sickle Cell Disease
Symptoms
Pain, redness, swelling, Purulence (drainage from infection site)
Open wound that probe to bone
Fever, Chills, Nausea, Vomiting
Loss of motion at the joint
Treatment
X-ray’s, MRI, CT and Bone scans may be performed to confirm the diagnosis of osteomyelitis and monitor its progression.
Conservative therapy:
This includes IV antibiotics, usually given for 6 weeks intravenously. Serial debridement may be performed to help decrease the bio burden.
Surgical intervention:
Most cases of osteomyelitis don’t go away with just IV antibiotics. The threshold to perform surgical intervention is low to prevent the spread of the bacteria. Debridement of bone is usually performed in the operating room down to healthy bone. Antibiotic spacers may be placed to help deliver antibiotics to the site of infection. Amputation may need to be performed if no viable bone is available. The surgical procedure of choice will be determined by the podiatric surgeon. surgeon
