Osteomyelitis

WHAT YOU SHOULD KNOW:

• Osteomyelitis is a severe infection of the bone. It may be acute (sudden), occurring within days or weeks, or chronic (long-standing), staying for months or years. Osteomyelitis can happen to anyone of any age and may affect any bone. It may be caused by different types of germs, including bacteria and fungi. Bacteria usually cause bone infection by infecting an open fracture (broken bone with open skin wound). You may also get osteomyelitis after a bone operation. Germs from another infection may also get to your bone by traveling through the blood. Anything that causes a weak immune system or poor blood flow may increase your risk for having osteomyelitis.
  
  
• Common signs and symptoms of a bone infection include pain, redness, or swelling of the infected bone area. You may have fever or night sweats. The infected area may be bruised or discolored, and there may be pus draining out of the skin. Different blood tests, bone biopsy and cultures, and different imaging tests of the bone, may be used for diagnosis. You may need medicines to fight the infection or surgery as treatment. With treatment, such as medicines and surgery, you have a greater chance of having a full recovery. Ask your caregiver about these tests and treatments.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Some osteomyelitis treatments cause side effects. You could bleed too much with surgery. Sometimes, even with treatment, the infection is not completely treated or may come back. You may have an allergic reaction or develop kidney problems with long-term use of strong antibiotics. If untreated, osteomyelitis can be very serious. A bone infection can spread to other bones or other parts of your body. It may cause bone death, which may lead to disability. The chances of treating osteomyelitis are better when diagnosed and treated as soon as possible. Ask your caregiver if you are worried or have questions about your disease, care, or treatment.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

An IV (intravenous)

is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

You may be given the following medicines:

• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  
• Antipyretics: This medicine is given to decrease a fever.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

Tests:

You may have one or more of the following tests:

• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Blood tests: Different blood tests may be done to see if you have an infection and what may be causing your infection. You may need to have blood taken for tests more than once.
  
  
• Bone biopsy and cultures: This is when a small piece of tissue is removed from your bone. This will be sent to the lab for tests. The sample taken will also be checked to learn what may be causing your infection. It can also tell your caregiver what medicines may best treat the infection.
  
  
• Imaging tests:
  
  
  • Bone scan: This is a test done to look at the bones in your body. The bone scan shows areas where your bone is diseased or damaged. You will get a radioactive liquid, called a tracer, through a vein in your arm. The tracer collects in your bones. Pictures will then be taken to look for problems. Examples of bone problems include fractures (breaks) and infection.
    
    
  • Computerized tomography scan: This test is also called a CT or CAT scan. An x-ray machine uses a computer to take pictures of your bone. Before taking the pictures, you may be given a dye through an IV in your vein. The dye helps the damaged bony areas and blood vessels show up better in the pictures. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell your caregiver if you are allergic to any of these.
    
    
  • Magnetic resonance imaging: This test is also called an MRI. During the MRI, pictures are taken of your bone. Caregivers use these pictures to look for damaged bony areas or infection in your bones. You will need to lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury. Tell your caregiver if you have any metal implants in your body.
    
    
  • X-rays: Pictures of your bone will help caregivers learn if you have broken or weak bones. Bone x-rays may also show if you have a bone infection or metallic implants causing problems.

Treatment options:

You may need surgery depending on the severity of your osteomyelitis. You may have one or more of the following:

• Debridement: This is surgery to remove part or all of the infected bone and some tissues around it. This may help keep the infection from spreading to other bones and parts of your body.
  
  
• Drains: These are thin rubber tubes put into your skin to drain fluid from around your incision. The drains are taken out when the incision stops draining.
  
  
• Revascularization: During revascularization, healthy muscle and skin flaps are put into areas where infection was removed. A large cavity or hole may remain when a large or deep infection is cleaned and removed. The muscle and skin flaps have good blood flow and help fill the cavity. Good blood flow is the best way to fight off old or new infections.
  
  
• Skin or bone grafting: This is when a thin piece of healthy skin or bone is removed from one part of the body. The healthy piece of skin or bone is then put onto the injured part of the body. When a large or deep infection is removed, a large wound or scar may occur. A skin graft can help close the wound or lessen the amount of scarring.
  
  
• Stabilization: Bones may be held together using metal pins, screws, or plates to keep them in their position. This may help correct broken bones that did not join together.
  
  
• Amputation: This is surgery to remove all or part of a limb (leg or arm). Amputation may be done if the bone infection is very bad and the limb cannot be saved. This may help keep the infection from spreading to other bones.

Learn more about Osteomyelitis (Inpatient Care)