Osteomyelitis

Question 1

Osteomyelitis

Answer 1

Severe infection of the bone, marrow, and surrounding soft tissue

Question 2

OM: Most common infecting organism

Answer 2

Staphylococcus aureus

Question 3

Is OM easy to cure?

Answer 3

NO!

-Extraordinarily difficult to cure

Question 4

Delayed identification of OM can lead to?

Answer 4

1. Chronic pain, infection, & drainage
2. Loss of function
3. Amputation
4. Death

Question 5

Factors that INCREASE likelihood of OM

Answer 5

1. IV drug use
2. Diabetes
3. Immunosuppression
4. Hx of blood infections
5. Presence of pressure ulcers/chronic open wounds
6. Limiting spread is complicated by:
   - Malnutrition
   - Alcoholism
   - Liver failure

Question 6

How does the bacteria gain entry?

Answer 6

Indirect: Blood Stream

Direct: Open Wound/Direct Entry

Question 7

Acute Osteomyelitis: Duration

Answer 7

< 1 month in duration

Question 8

Chronic Osteomyelitis: Duration

Answer 8

> 1 month or has failed to respond to initial antibiotics

• Can be continuous & persistent (resulting from inadequate acute treatment) OR
• a process of remission & exacerbations

Question 9

Acute Osteomyelitis: LOCAL Manifestations

Answer 9

• Constant bone pain that worsens with activity/unrelieved by rest
• Swelling, tenderness, & warmth at infection site
• Restricted movement of affected part

Question 10

Acute Osteomyelitis: SYSTEMIC Manifestations

Answer 10

• Fever + chills
• Night sweats
• Restlessness
• Nausea
• Malaise

Question 11

Chronic Osteomyelitis: LOCAL Manifestations

Answer 11

*Local manifestations are more common

• Constant bone pain
• Swelling
• Warmth at site

Question 12

Chronic Osteomyelitis: SYSTEMIC Manifestations

Answer 12

Systemic manifestations are REDUCED with chronic OM

Question 13

OM Diagnostics

Answer 13

1. Bone/tissue biopsy (to determine causative organism)
2. Blood & Wound culture (+)
3. ↑ WBC/ ↑ ESR
4. X-ray (results do NOT show changes until 10 days after infection) ☢

***5. Radionuclide bone scans (preferred)

6. MRI

Question 14

OM: Collaborative Care

Answer 14

◉Vigorous/prolonged IV antibiotics (PICC line)

◉Surgical debridement

◉Some immobilization of affected limb; initially may be on bedrest

◉Pain control