Bone infection (osteomyelitis)
Osteomyelitis is a bone infection. It may sometimes be treated if the correct antibiotics are given early. If not, it can cause permanent damage. Bone infections are caused by bacteria which can enter the bone via the bloodstream if there is an infection nearby or can be caused by an ‘open’ fracture or other injury where a wound penetrates to the bone.
What causes bone infection?
You are more at risk of getting an infection in a bone if you have:
- Recently broken (fractured) a bone
- Been injured or have a wound
- Have an artificial hip, or a screw in a bone
- Have recently had any surgery on a bone
- A weakened immune system – for example, because of chemotherapy or you have another serious illness
- Had a bone infection in the past
- Diabetes, especially if you also have a foot ulcer
- Sometimes an infection in the blood affects the bone or joints
- Pain, swelling, redness and a warm sensation over the affected area
- A very high temperature (or you feel hot and shivery) and feel generally unwell
- If you have had a bone infection before and you think symptoms have come back
In children, they may not want to use an arm or leg and may seem irritable. Young children don’t always get a high temperature with osteomyelitis.
Your consultant will discuss your symptoms with you and will advise on the best course of treatment. They may also arrange for you to have blood tests and X-rays along with an MRI scan and CT scan to show the problem in greater detail and confirm the diagnosis.
The most important step in bone infection is to be certain of the diagnosis and the extent of the infection. In very mild cases it may be treated with antibiotics. However, if there are screws, plates or other implants used to fix bones or replace joints you may need to have an operation. This would be to remove the implants, remove dead and infected bone and then stabilise the remaining bone.
At the time of the operation deep samples are sent to the laboratory to find out the exact type of bacteria that is causing the infection. This then allows the correct antibiotics to be prescribed for you.
You may have to stay in hospital to get antibiotics directly into a vein (intravenously). When you start to get better you might be able to take antibiotic tablets at home.
You’ll usually take antibiotics for 4 to 6 weeks. If you have a severe infection, the course may last up to 12 weeks. It’s important to finish a course of antibiotics even if you start to feel better.
You can take painkillers to ease the pain. If the infection is in a long bone (such as an arm or leg), you may be fitted with a splint so you don’t move it as often.
Infected bone can die (necrosis), causing bone loss; if this happens then you may need to have surgery so that the bone can be reconstructed.