Bone Infection: (Osteomyelitis) A Path That a Diabetic Patient Does Not Want to Travel

Osteomyelitis is a bone infection that is caused when a bacteria or fungi invades the bone. Most of the time when osteomyelitis occurs, the ulcer or infection has been there for a long period of time. It starts with an open wound on the foot that has been either neglected or not treated. The foot presents with a foul odor, warmth to the skin, pus or purulent drainage coming from the wound, and extreme pain upon ambulation or palpation of the infected site. 

The most common sites for bone infections in children appear in the long bones of the arms and the legs. The most common sites in adults appear in the hips, feet, and spine. It is very important to have a bone infection treated very early in the process. There can be permanent damage to vital structures of the human body if early and proper treatment is not rendered. 

The Causes of Osteomyelitis

The most common bacteria to cause osteomyelitis is Staphylococcus aureus. This bacterium is very powerful as it can travel from outside the body and invade the skin source to the skin and then travel to the bone via the bloodstream.  

These bacterias can get inside deep wounds and cause major damages to surrounding bones. Bacteria can enter the surgical site, such as the site of a great toe implant or a metatarsal fracture repair. As the bone breaks, bacteria gets inside the bone causing osteomyelitis. 

What are the Symptoms?

• Redness or Erythema in the site
• Drainage from the area
• Swelling
• Stiffness
• Chills and Fever
• Pain upon palpation or ambulation

How to Diagnose Osteomyelitis?

• X-ray
• MRI
• Bone Scans
• Bone Biopsy or Bone culture

Treatments of Osteomyelitis

Sometimes antibiotics can be all that is needed to destroy that bone infection. It may need to be administered intravenously or directly to your veins. In the worse cases, the antibiotics may need to be taken for up to 6 weeks. 

When these bone infections require surgery, the infected bone and all the necrotic tissue are removed by performing exploration and drainage of the infected site. To drain the abscess, purulent discharge, or pus pockets, the surgical site is irrigated or flushed with antibiotic solutions. 

In the most severe cases of bone infections, antimicrobial beads, implanted beads that have a mixture of antibiotics usually vancomycin or gentamycin will be implanted deep into the wound to preserve and prevent the other bones from being infected.  

The Highest Risk for Getting Osteomyelitis

• Diabetics: They have poor blood supply to the bone and the mixture of peripheral neuropathy that can lead to bone destruction.
• Sickle Cell Disease.
• End-Stage Renal Disease (ESRD).
• Peripheral Vascular Disease (PVD).
• Trauma to tissue surrounding the bone.
• Smoking.
• Artificial joints or hardware that has become infected.
• Peripheral Arterial Disease (PAD).

Preventing Osteomyelitis

You must thoroughly clean all wounds, cuts, and open lesions daily. You must follow up with your treating physician on a regular basis. There are wound care centers where trained health care professionals will treat the wounds on a regular basis. Also, the use of proper footwear is an important concept to make sure that lesions are prevented.

Long-Term Objectives

Osteomyelitis is treatable and preventable. Just like diabetic foot infections, bone infections do not happen in one day. Bone infections are usually chronic and are the last stage of any infection. Bone infections usually come into play because of neglect. The treating physicians must be very aggressive to prevent amputations and multiple bone resections. If caught early and the bone infection treated properly, the outlook for bone infections is promising to prevent further amputations and multiple bone infections.