Tuesday, March 3, 2009

What Is Osteomyelitis?

This info came from kidshealth.org/teen/diseases_conditions/bones/osteomyelitis.html

Osteomyelitis (pronounced: os-tee-oh-my-uh-lie-tus) is a bone infection often caused by bacteria called Staphylococcus aureus (pronounced: sta-fuh-low-kah-kus are-ee-us). Depending on how the bone becomes infected and the age of the person, other types of bacteria can cause it, too. In kids and teens, osteomyelitis usually affects the long bones of the arms and legs.
Bacteria can infect bones in a number of ways. Bacteria can travel into the bone through the bloodstream from other infected areas in the body. This is called hematogenous (pronounced: heh-meh-tah-gen-us) (hema refers to the blood) osteomyelitis, and is the most common way that people get bone infections.

Kally had a scratch on her arm for several weeks before all of this happened. She kept picking the scab and it did look pretty red. We ask the doctors if this could have been the cause and they said that it was possible, but they didn't think so. Who knows though. Tell your kids not to pick there scabs!

Another way is by direct infection, when bacteria enter the body's tissues through a wound and travel to the bone (like after an injury). Open fractures — breaks in the bone with the skin also open — are the injuries that most often develop osteomyelitis.
A bone also can become infected when the blood supply to that area of the bone is disrupted. This can happen in older people with atherosclerosis (pronounced: ath-uh-row-skluh-row-sis), which is a narrowing of the blood vessels, or in association with diabetes. Most infections of this kind occur in the toes or feet.

Kally didn't have any specific injuries before this infection. She just woke up one morning and it hurt

What Are the Signs and Symptoms?
People with osteomyelitis often feel severe pain in the infected bone. They might have fever (Kally did not have a fever) and chills, feel tired or nauseated, or have a general feeling of not being well. The skin above the infected bone may be sore, red, and swollen. Kally's foot was swollen the first day she complained it hurt, but it wasn't until after five days of pain, her foot started to get a few red spots and felt warm. It's sometimes difficult to diagnose osteomyelitis in infants and young children because they don't always show pain or specific symptoms in the area of the infection. Also, older people with diabetes or another problem with their blood vessels don't always show signs of fever or pain. For teenagers, it's frequently a preceding accident or injury that leads to the infection.
If the osteomyelitis developed after an open wound, the injured area may begin to hurt again after initially seeming to get better.

What Do Doctors Do?
If you have symptoms such as fever and bone pain, you should see your doctor. It's a good idea to go as soon as possible because osteomyelitis can quickly get worse and become much more difficult to get rid of.
The doctor probably will do a physical examination and ask questions about any recent injuries to the area where you have pain. It's likely, too, that the doctor will perform blood tests to see whether your white blood cell count is elevated (a sign of infection) and to look for signs of possible inflammation or infection in the body. The doctor will take your medical history by asking about any concerns and symptoms you have, your past health, your family's health, any medications you're taking, any allergies you may have, and other issues.
Often, the doctor will take a bone X-ray, which may show whether an infection in the bone is present. However, X-rays may not show signs of infection if someone who has had osteomyelitis for only a short while. If the doctor strongly suspects osteomyelitis, he or she may suggest a test called a bone scan that provides a more detailed look at the bone. A doctor might also recommend an MRI (magnetic resonance imaging), which produces much more detailed images than X-rays. MRIs not only can diagnose osteomyelitis, but also can help establish how long the bone has been infected. Kally did everything listed in the above paragraph, but it took 6 days of pain and 4 different doctor visits before they were able to diagnose the problem.
Treatment of osteomyelitis depends on the severity of the infection and whether it is acute (recent) or chronic (has been present for a longer period of time). The doctor may use a needle to remove a bacteria sample from the bone to help identify the bacteria responsible for the infection. This is called needle aspiration. The doctor will then be able to choose the correct antibiotic to treat that particular infection. Kally didn't have to do this.
In some cases, osteomyelitis can become severe and a cavity or hole may develop in the bone. Pus — a large collection of bacteria and white blood cells — may have formed in this cavity. If this happens, the doctor can perform a surgical procedure to help drain the pus out of the bone so that the bone can heal properly. Kally had a small absess (5mm) in the muscle below the infected area that they found in the MRI, but the doctors determined that antibiotics would heal it and surgury wouldn't be necessary.
Osteomyelitis can be difficult to treat. After being diagnosed with osteomyelitis, you may be admitted to the hospital for a short stay so that intravenous (IV) antibiotics can be given (directly into a vein) to fight the infection. Once the condition improves, you will be allowed to go home but you may continue to need IV or oral (taken by mouth) antibiotics at home for several more weeks.
Kally will be on the IV antibiotics for at least 4 weeks. The homecare nurses will come once a week to replace the dressings on her IV and take blood samples to test inflamitory levels. After the 4 weeks we will see the Infectious Disease doctors again for a follow up. As long as the levels continue to go down and the pain goes away, she will recover 100% and be back to playing soccer and dance in April.

Most teens recover completely from osteomyelitis.
Can I Prevent Myself From Getting Osteomyelitis?
The easiest way to prevent yourself from getting osteomyelitis is to practice good hygiene. If you get a cut or a wound — especially a deep wound — make sure you clean it thoroughly. Wash it with soap and water, holding it under running water for at least 5 minutes to flush it out.
To keep the wound clean afterward, you should cover it with sterile gauze or a clean cloth. You can apply an over-the-counter antibiotic cream, too, but the most important thing is to keep the injury clean. Be sure to see your doctor, especially if you have a wound that's not healing or if you're continuing to have pain.

6 comments:

jase said...

I was 12 when I woke up one morning with my left foot hurting so bad I couldn't put any weight on it. It took at least two weeks for the doctors to diagnose. I had blood drawn at least 13 times, and my arm veins still stand out well because of that.

The worst part was the procedure of determining exactly what type of infection I had. They put several needles in my foot to get samples out. But before that they gave me a dose of morphine to kill the pain and every other possible sensation. It felt like ice water going in and I started shaking uncontrollably, which was terrifying and brought me to tears.

I was in the hospital with an IV for a week. The best part was I missed the last four weeks of attending school. I took antibiotics at home for another few weeks, they were horrible. If you've ever taken you know what I mean.

Camille said...

Wow, that is so sad and so crazy. Sorry to hear you guys have been through that.....

I sent you an email to the address you gave me- but I may have did it wrong...?
Just want to make sure you got my email....
Thanks, Camille

Kristen said...

Camille, I've sent several back to you too. Are you not getting them. My email is acting weird lately. I just sent you another one. Let me know if you get it.

Mandy said...

Kristen we are glad to hear she is feeling better! We hope she does well! She sounds like a trooper!! All that info was good! I am glad you shared that some of those thing you don't really think about or realize!! GLad to hear it all is going ok! If you need anything any time or hour of the night whatever. Mike is a nurse also so he could try and help! Just call really not a problem he doesn't mind!! Take care and we wish you luck!

Camille said...

no sorry- I didn't get your email....
try again
lv_Camille@yahoo.com

Camille said...

still nothing...... (sorry to be a pain)

lv_camille@yahoo.com