What are the other Names for this Condition? (Also known as/Synonyms)

• Acute Bone Infection

What is Acute Osteomyelitis? (Definition/Background Information)

• Osteomyelitis indicates an inflammation of the bone due to a variety of reasons including infections. In case of infections, the condition is commonly caused by a bacteria or fungus.
• Osteomyelitis is classified into acute, subacute, and chronic forms.
• Acute Osteomyelitis is a condition that develops within two weeks of an injury or initial infection. It is most commonly seen in children.
• Staphylococcus aureus is the most common bacterium causing the infection. It involves the highly vascular long bones, especially those of the lower legs.
• The common signs and symptoms of Acute Osteomyelitis are severe pain and restriction of movements in the affected region.
• Antibiotics are the mainstay of treatment for Acute Osteomyelitis. With appropriate treatment, this condition has an excellent prognosis.

Who gets Acute Osteomyelitis? (Age and Sex Distribution)

• Acute Osteomyelitis affects both children and adults, but it is more common in children
• It can affect children below 2 years, or children in the age group of 8-12 years
• The infection is more common in males than in females
• The condition is seen worldwide; no race or ethnicity is particularly preferred

What are the Risk Factors for Acute Osteomyelitis? (Predisposing Factors)

The risk factors associated with Acute Osteomyelitis include:

• Gender: Males are more affected than females
• Age: Children are at higher risk of contracting Acute Osteomyelitis
• Infections: A previous history of Acute Osteomyelitis
• Intravenous drug abusers: Those who use intravenous drugs have a weak immune system and hence, carry a higher risk of Acute Osteomyelitis
• Patients on dialysis get infections easily and hence, have a high risk
• Patients with urinary catheters
• Individuals with poor or weakened immune system
• Individuals with chronic diseases, such as diabetes, peripheral arterial disease, and sickle cell disease
• Injuries: A deep, punctured wound or a broken bone can lead to the onset of Acute Osteomyelitis
• Bone surgery: Surgery to repair bones or replace joints carries a high risk of susceptibility to the condition

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Acute Osteomyelitis? (Etiology)

A bacterial or fungal infection can develop within the bone from direct inoculation, or reach the bone from another part of the body. When an infection develops inside the bone, the body’s immune system will try to destroy it by using neutrophils, which are a type of white blood cell. If the infection remains in the body and is left untreated, the dead neutrophils get accumulated inside the bone, forming an abscess. The abscess will block the flow of blood to the affected area. This results in osteomyelitis.

The possible causes for Acute Osteomyelitis may be:

• A pre-existing blood infection spreading to the bone
• A bone fracture or an injury to the bone
• Pre-existing chronic diseases, like diabetes, can lead to Acute Osteomyelitis by blocking the supply of white blood cells, which fight against infection in the affected area

Common bacteria responsible for Acute Osteomyelitis are:

• Staphylococcus aureus
• Group A streptococci
• Haemophilus influenzae

What are the Signs and Symptoms of Acute Osteomyelitis?

The signs and symptoms of Acute Osteomyelitis could include:

• Pain and tenderness in the affected area
• Warmth in the affected bone
• Redness in the affected area
• Mild fever, lethargy
• Loss of movement in the affected area or limb
• Irritability

How is Acute Osteomyelitis Diagnosed?

The diagnostic of Acute Osteomyelitis may include:

• Physical examination: The physician will conduct a physical examination for signs and symptoms of Acute Osteomyelitis
• Medical history: The physician will also carefully examine the medical history of the affected individual

Some of the diagnostic tests used may include:

• Blood tests: Tests are conducted to check the available blood count and the kind of germs present in blood
• X-rays of the affected region to show the extent of damage that has occurred
• Magnetic resonance imaging (MRI) scan of the affected region: When x-rays are not very informative, an MRI scan is done to get a more clearer picture
• Bone scans are helpful during the early stage of the disease, when x-rays do not show the presence of the disease
• Tissue biopsy: A tissue sample is sent to a pathology lab for examination under a microscope. The pathologist examines the biopsy sample which can help make a definitive diagnosis. The pathologist may also perform certain additional studies to arrive at a conclusion

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Acute Osteomyelitis?

The complications that occur with Acute Osteomyelitis may include:

• Chronic osteomyelitis: When Acute Osteomyelitis is left untreated, it may lead to chronic osteomyelitis, which is more dangerous and may result in the death of the bone tissue, causing permanent bone damage
• Risk of recurrence: Patients who have already had an episode of chronic osteomyelitis, have an increased risk of recurrence of the infection
• Amputation: When the condition becomes severe and it is not possible to be treated with conservative measures, then amputation of the limb (foot or arm) may be required

How is Acute Osteomyelitis Treated?

The treatment for Acute Osteomyelitis may include:

• A course of antibiotics and antifungal medications
• Antibiotics are given for 4-6 weeks; often times, intravenous (given through vein) antibiotics are required
• If the infection is caused by a drug-resistant bacteria, a longer course of antibiotics, as well as a combination of different medications, are recommended
• If the infection does not respond to medications, then surgery is required to remove the dead bone.

How can Acute Osteomyelitis be Prevented?

Preventive measures to be adopted for Acute Osteomyelitis may include:

• For patients with a weak immune system:
  • Eating a well-balanced and healthy diet
  • Avoidance of smoking
  • Regular exercise will improve the immunity
  • Regular and proper hand washing
  • Ensure an updated immunization status
• For patients with poor blood circulation:
  • Eating a well-balanced and healthy diet
  • Avoidance of smoking
  • Regular exercise
  • Reduction in alcohol consumption is helpful
• For cuts and scrapes:
  • If you are vulnerable to infections, take utmost precaution to avoid cuts and scrapes
  • When you have a cut, clean it thoroughly and put a bandage over it
  • Check the wounds regularly to ascertain if an infection has developed

What is the Prognosis of Acute Osteomyelitis? (Outcomes/Resolutions)

With appropriate treatment, Acute Osteomyelitis has an excellent prognosis.

Additional and Relevant Useful Information for Acute Osteomyelitis:

Chronic osteomyelitis is a severe, persistent, incapacitating infection of the bone, which develops after two months of an injury or initial infection.