It is a purulent bone infection of both the cortex and marrow components.
In most cases, it is caused by bacteria, but it can also be caused by fungi or other germs. Risk factors include diabetes, hemodialysis, poor blood circulation, recent injury, use of injected illicit drugs, surgery involving bones, and weakened immune systems.
Clinical manifestations are not specific and vary with age, including bone pain, excessive sweating, fever and chills, general discomfort, restlessness, feeling unwell (malaise), swelling, local redness and heat, open wound that may show pus and pain at the site of infection.
The diagnosis is made through medical history, physical examination and additional tests including blood cultures, bone biopsy (the sample is cultured and examined under a microscope), bone scintigraphy, bone x-ray and blood tests.
The goal of treatment is stopping the infection and reducing damage to the surrounding bone and tissues. It requires prolonged antibiotic therapy and symptom control. In some cases, it may require surgical debridement.- Tahaniyat Lalani, MBBS, MHS. Overview of osteomyelitis in adults. Uptodate. Feb 21, 2017.
- Ganesh D, Gottlieb J, Chan S, et al. Fungal Infections of the Spine. Spine (Phila Pa 1976) 2015; 40:E719
- Lew DP, Waldvogel FA. Osteomyelitis. Lancet 2004; 364:369.
- Álvaro-Afonso FJ, Lázaro-Martínez JL, Aragón-Sánchez FJ, et al. Does the location of the ulcer affect the interpretation of the probe-to-bone test in the diagnosis of osteomyelitis in diabetic foot ulcers? Diabet Med 2014; 31:112.
- Gomis Gavilán M. Osteomielitis. Farreras Rozman. Medicina Interna. Volumen 1. 12º edición. 1104:1107.
