Osteomyelitis

Osteomyelitis

Osteomyelitis is the medical term for an infection of the bone or bone marrow (derived from the Greek words osteo- meaning bone and myelo- meaning marrow). On the basis of the causative organism, the route, the duration, and the anatomic location of the infection, it can be helpfully sub-classified.

Diagnosis

• Complete physical examination: Look for the sign or symptoms of soft tissue and bone tenderness and possibly swelling and redness.
• Blood tests: It includes – complete blood count, ESR, CRP, etc.
• Blood culture: Blood culture is a test used to detect bacteria and tested against different antibiotics in hopes of finding the most effective treatment.
• Needle aspiration: During this test, a needle is used to remove a sample of fluids and cells from the vertebral space, or bony area.
• Biopsy: A biopsy of the infected bone may be taken and tested for signs of an invading organism.
• X-ray: A diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
• Computed tomography scan: A diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images, both horizontally and vertically.
• Magnetic resonance imaging: A diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body.

Treating and managing osteomyelitis

• Medical Management
  • Analgesics as prescribed.
  • Antibiotic as prescribed.
  • Dressing changes- use sterile technique.
  • Maintain proper body alignment and change position frequently to prevent deformities.
• Surgical Management
  • Splinting or cast immobilization: this may be necessary to immobilize the affected bone and nearby joints in order to avoid further trauma and to help the area heal adequately and as quickly as possible.
  • Incision and Drainage of a bone abscess. If there are an open wound and abscess, it may be drained through a procedure called needle aspiration. In this procedure, a needle is inserted into the affected area and the fluid is withdrawn.
  • Sequestrectomy: removal of dead, infected bone and cartilage.
  • Bone grafting: it is recommended after repeated infections.
  • Remove any foreign objects: in some cases, a foreign body such as surgical plates or screws placed during a previous surgery, may have to be removed.
  • Amputate the limb: as a last resort, surgeons may amputate the affected limb to stop the infection from spreading further.

Osteomyelitis

Osteomyelitis is the medical term for an infection of the bone or bone marrow (derived from the Greek words osteo- meaning bone and myelo- meaning marrow). On the basis of the causative organism, the route, the duration, and the anatomic site of the infection, it may be helpfully sub-classified.

Path physiology

In most cases, bone is resistant to infection. Osteomyelitis, however, can develop when germs from nearby structures or from direct inoculation associated to surgery or trauma are introduced into bone hematogenous. Treatment for trauma may lead to bone infection, which enables pathogens to enter bone and multiply in the traumatized tissue. The infection that results when a bone infection lasts for months may be polymicrobial and is known as chronic osteomyelitis. Although infections can affect any bone, they most frequently affect the lower extremity.

Some important factors in the pathogenesis of osteomyelitis include the virulence of the infecting organism, underlying disease, immune status of the host, and the type, location, and vascularity of the bone. Bacteria may possess various factors that may contribute to the development of osteomyelitis. For example, factors promoted by S aureus may promote bacterial adherence, resistance to host defense mechanism, and proteolytic activity.

Sign and Symptoms

• Pain or tenderness in the infected area.
• Swelling and warmth in the infected area.
• Fever.
• Nausea, secondarily from being ill with infection.
• General discomfort, uneasiness, or ill feeling.
• Drainage of pus through the skin.
• Excessive sweating.
• Chills.
• Lower back pain.

Diagnosis

• Complete physical examination:  Look for the sign or symptoms of soft tissue and bone tenderness and possibly swelling and redness.
• Blood tests: it includes – complete blood count, ESR, CRP, etc.
• Blood culture: blood culture is a test used to detect bacteria and tested against different antibiotics in hopes of finding the most effective treatment.
• Needle aspiration: during this test, a needle is used to remove a sample of fluids and cells from the vertebral space, or bony area.
• Biopsy: a biopsy of the infected bone may be taken and tested for signs of an invading organism.
• X-ray: a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
• Computed tomography scan: a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images, both horizontally and vertically.
• Magnetic resonance imaging: a diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body.

Treating and Managing Osteomyelitis

• Medical Management
  • Analgesics as prescribed
  • Antibiotic as prescribed
  • Dressing changes- use sterile technique
  • Maintain proper body alignment and change position frequently to prevent deformities.
• Surgical Management
  • Splinting or cast immobilization: this may be necessary to immobilize the affected bone and nearby joints in order to avoid further trauma and to help the area heal adequately and as quickly as possible.
  • Incision and Drainage of a bone abscess. If there are an open wound and abscess, it may be drained through a procedure called needle aspiration. In this procedure, a needle is inserted into the affected area and the fluid is withdrawn.
  • Sequestrectomy: removal of dead, infected bone and cartilage.
  • Bone grafting: it is recommended after repeated infections.
  • Remove any foreign objects: in some cases, a foreign body such as surgical plates or screws placed during a previous surgery, may have to be removed.
  • Amputate the limb: as a last resort, surgeons may amputate the affected limb to stop the infection from spreading further.

Nursing Management

• Consider the vital signs, the look of the wound, and any new discomfort that could point to a secondary infection.
• A fracture may be indicated by a sudden malpositioning of the afflicted limb.
• Keep track of the neurovascular situation and the infection region.
• Use firm cushions to support the injured limb.
• Use non-pharmacological methods and the prescription analgesics to manage the patient's discomfort.
• When changing the dressing and irrigating wounds, use rigorous aseptic approach.
• Observe how he responds to the antibiotics.
• Provide nutritional assistance in the form of a high-protein diet, unless contraindicated.
• Care should be directed toward preventing infection, preserving bone health, and offering support.
• To aid in healing, offer a wholesome diet.
• Exercise the joints above and below the affected area's range of motion gently.
• Observe for the signs of complication.