osteomyelitidy

Osteomyelitis is a serious bone infection typically caused by bacteria, though fungi and other pathogens can also be responsible. The condition primarily affects the bone marrow and surrounding bone, leading to inflammation, pain, and potential tissue damage. Osteomyelitis can occur in both children and adults, with risk factors including open fractures, surgical procedures, diabetes, peripheral vascular disease, and compromised immune systems.

The infection may develop through several pathways, including direct contamination from an open wound, spread of bacteria from a nearby infection (such as cellulitis or a joint infection), or hematogenous spread (via the bloodstream) from a distant site, such as a urinary tract or respiratory infection. Acute osteomyelitis often presents suddenly with localized pain, swelling, warmth, and redness at the infected site, while chronic osteomyelitis may develop gradually with persistent symptoms, including drainage from a sinus tract and intermittent fever.

Diagnosis involves a combination of clinical evaluation, imaging studies such as X-rays, CT scans, or MRI, and laboratory tests, including blood cultures and bone biopsies. White blood cell counts, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels may also be elevated. Treatment typically requires a prolonged course of intravenous or oral antibiotics, tailored to the specific pathogen identified. In severe cases, surgical intervention—such as debridement or removal of infected bone—may be necessary to eliminate the infection and restore function.

Prevention focuses on proper wound care, timely treatment of infections, and management of underlying conditions that increase susceptibility. Early diagnosis and aggressive treatment are critical to preventing complications, such as bone destruction, sepsis, or long-term disability. Chronic osteomyelitis can be particularly challenging to treat due to antibiotic resistance and the formation of biofilms, necessitating a multidisciplinary approach involving infectious disease specialists, orthopedic surgeons, and other healthcare providers.