Osteomyelitis is a bone infection caused by bacteria or fungi. It causes painful swelling of bone marrow, the soft tissue inside your bones. Without treatment, swelling from this bone infection can cut off blood supply to your bone, causing bone to die. Osteomyelitis affects about 2 to 5 out of every 10,000 people. It’s one of the oldest diseases on record.
Certain bones in your skeletal system, such as the hip and thighbones, contain soft, spongy tissue. This tissue, called bone marrow, makes stem cells that produce blood cells and platelets.
Types of osteomyelitis include –
This infection comes on suddenly. You may have a fever and then develop pain in the infected area days later.
Chronic osteomyelitis is a bone infection that doesn’t go away with treatments. It causes bone pain and recurring drainage (pus). Rarely, chronic osteomyelitis doesn’t have symptoms. The infection may go undetected for months or even years.
This type affects the spine. It causes chronic back pain that gets worse when you move. Treatments like resting, heating and pain relievers don’t help. It rarely causes a fever. People who live in nursing homes, misuse intravenous drugs or are on dialysis are more prone to spinal bone infections.
Usually, the first symptom to appear is pain at the infection site. Other common symptoms are –
• fever and chills
• redness in the infected area
• irritability or generally feeling unwell
• drainage from the area
• swelling in the affected area
• stiffness or inability to use an affected limb
Most cases of osteomyelitis are caused by staphylococcus bacteria, types of germs commonly found on the skin or in the nose of even healthy individuals.
Germs can enter a bone in a variety of ways, including –
• The bloodstream.
Germs in other parts of your body — for example, in the lungs from pneumonia or in the bladder from a urinary tract infection — can travel through your bloodstream to a weakened spot in a bone.
Severe puncture wounds can carry germs deep inside your body. If such an injury becomes infected, the germs can spread into a nearby bone. Germs can also enter the body if you have broken a bone so severely that part of it is sticking out through your skin.
Direct contamination with germs can occur during surgeries to replace joints or repair fractures.
Risk Factors –
The condition affects children and adults, although in different ways. Certain conditions and behaviors that weaken the immune system increase a person’s risk for osteomyelitis, including –
• Diabetes (most cases of osteomyelitis stem from diabetes)
• Sickle cell disease
• HIV or AIDS
• Rheumatoid arthritis
• Intravenous drug use
• Long-term use of steroids
• Poor blood supply
• Recent injury
Bone surgery, including hip and knee replacements, also increase the chance of bone infection.
In children, osteomyelitis is usually acute. Acute osteomyelitis comes on quickly, is easier to treat, and overall turns out better than chronic osteomyelitis. In children, osteomyelitis usually shows up in arm or leg bones.
Osteomyelitis complications may include –
• Bone death (osteonecrosis).
An infection in your bone can impede blood circulation within the bone, leading to bone death. Areas where bone has died need to be surgically removed for antibiotics to be effective.
• Septic arthritis.
Sometimes, infection within bones can spread into a nearby joint.
• Impaired growth.
Normal growth in bones or joints in children may be affected if osteomyelitis occurs in the softer areas, called growth plates, at either end of the long bones of the arms and legs.
• Skin cancer.
If your osteomyelitis has resulted in an open sore that is draining pus, the surrounding skin is at higher risk of developing squamous cell cancer.
After assessing your symptoms and performing a physical exam, your healthcare provider may order one or more of these tests –
• Blood tests
A complete blood count (CBC) checks for signs of inflammation and infection.C-reactive protein when on higher concentrations indicate inflammation. A blood culture looks for bacteria in your bloodstream.
• Imaging tests
X-rays, MRIs, CT scans and ultrasounds provide images of your bones, muscles and tissues.
• Bone scan
A bone scan uses a small amount of safe, radioactive material to identify infections or fractures during an imaging scan.
Your healthcare provider performs a needle biopsy to take samples of fluid, tissue or bone to examine for signs of infection.
A bone infection can take a long time to heal. The infection may clear up faster if you start treatment within three to five days of first noticing symptoms.
Treatment include –
Antibiotics kill infection-causing bacteria. You may need antibiotics for four to eight weeks, starting with intravenous (IV) antibiotics in the hospital for a week or two. You’ll then take medications by mouth for several weeks. Chronic infections may require months of antibiotics.
To treat fungal infections, you may need to take oral antifungal medications for months.
• Needle aspiration
Your healthcare provider uses a fine needle to drain fluid and pus from the abscess.
• Pain relievers
Nonsteroidal anti-inflammatory drugs (NSAIDs) treat pain and inflammation.
Surgery is sometimes needed to treat bone infections. You’ll need antibiotics after surgery. Surgical options include –
• Bone surgery
Your healthcare provider surgically removes (debrides) infected dead tissue and bone. This procedure may result in bone deformities.
• Spine surgery
People with vertebral osteomyelitis may need spine surgery. This procedure keeps vertebrae from collapsing and damaging your spinal cord, nerves and other parts of your nervous system.
Ayurvedic Perspective –
According to ayurveda this is the condition affecting asthi dhatu (bone), the causative factors for these are mentioned as nija(within the body) and aganthuj(outside),which will be leading to the asthi dhathvagni vaigunyam ( bone formation). When this get blocked the proper formation of the bone will be impaired and the surrounding tissues also get affected, resulting in the dhathu pakam(destruction). By controlling the dhathu pakam and maintaining a proper asthidhatvagni the condition can be effectively treated in ayurveda.
Different external application mainly antioxidative herbal formulation are clearly indicated for this condition, special internal medicines to increase immunity and bone formation are mentioned. specilized detoxification methods along with whole body cleansing techniques will remove the bacterial atmosphere, thus control the progression.
Varandi kashayam, Phaltrikadi Kashyam, Chaturmukhrasa, Vasant kusumakar rasa, Kaishor Guggul aresome of the formulations works efficiently in such condition. Along with this, externally lepa of Mahasneham gives complimentary effect.
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