OSTEOMYELITIS |
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DESCRIPTIONOsteomyelitis is an infection of the bone and bone marrow. Any bone in the body can be involved. In a child, the femur (upper-leg bone), the tibia (lower-leg bone), or the humerus or radius (bones in the arm) are usually affected. In an adult, the pelvis or spine are usually affected. Osteomyelitis occurs in both sexes but is more common in males. It can affect all ages but is most common in rapidly growing children (5 to 14 years).
Appropriate health care includes:
Physician's monitoring of general condition and medications.
Hospitalization for surgery to drain abscesses or to remove pockets of infected bone, and to administer high doses of antibiotics--sometimes intravenously.
Self-care after diagnosis and when hospitalization is no longer necessary.
SIGNS & SYMPTOMS
Fever. Sometimes this is the only symptom.
Pain, swelling, redness, warmth, and tenderness in the area over the infected bone, especially when moving a nearby joint. Nearby joints--especially the knee--may also be red, warm, and swollen.
If a child is too young to talk, signs of pain include reluctance to move an arm or a leg, or refusing to walk, or limping, or screaming when the limb is touched or moved.
Pus drainage through a skin abscess, without fever or severe pain (chronic osteomyelitis only).
General ill feeling.
CAUSES
Usually staphylococcal infection, but many other bacteria may be responsible. The bacteria may spread to the child's bone through the bloodstream from the following sources: compound fracture or other injury; boil, carbuncle, or any break in the skin; middle-ear infection; pneumonia.
RISK FACTORS
Illness that has lowered resistance.
Rapid growth during childhood.
PREVENTING COMPLICATIONS OR RECURRENCEObtain prompt medical treatment for your child for any bacterial infection to prevent its spread to bone or other body parts.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms; medical history and physical exam by a doctor; laboratory blood studies and blood cultures to identify the bacteria.
X-rays of the bone. X-rays often don't show changes until 2 to 3 weeks after the infection begins.
CAT or CT Scan (See Glossary).
POSSIBLE COMPLICATIONS
Abscess that breaks through the child's skin and won't heal until the underlying bone heals.
Permanent stiffness in a nearby joint (rare).
Blood poisoning that makes amputation necessary (rare).
PROBABLE OUTCOME
Usually curable with prompt and aggressive treatment.
TREATMENT
HOME CARE
Wear sterile gloves to change your child's dressings.
Keep the involved limb level or slightly elevated and immobilized with pillows. Don't let it dangle.
Keep unaffected parts of the child's body as active as possible to prevent pressure sores during required prolonged bed rest.
MEDICATION
Your doctor may prescribe:
Large doses of antibiotics, usually intravenously. Antibiotics may be necessary--either orally or by injection--for 8 to 10 weeks.
Pain relievers.
Laxatives, if constipation develops during prolonged bed rest.
ACTIVITY
Your child should rest in bed until 2 to 3 weeks after symptoms disappear. Normal activities may be resumed gradually.
DIET & FLUIDS
No special diet. Urge your child to eat heartily. Give the child vitamin and mineral supplements.
OK TO GO TO SCHOOL?When signs of infection have decreased, appetite returns, and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of osteomyelitis.
The following occurs during treatment: An abscess forms over the infected bone, or drainage from an existing abscess increases; fever rises to 101F (38.3C) or higher; pain becomes intolerable.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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