Frequently Asked Questions (FAQs) about Osteomyelitis

Osteomyelitis is an infection of the bone or bone marrow that can lead to a number of serious health problems. Below are some of the most frequently asked questions that patients and their loved ones have about osteomyelitis and the available treatment options for this condition.

What is osteomyelitis?

Osteomyelitis is an infection of the bone or bone marrow . Post-traumatic osteomyelitis occurs when bone is directly contaminated by bacteria or fungi that live in or on the patient's skin or are from the environment; these infections are most common after an injury or a surgical procedure where in the bone is exposed to the air.  When osteomyelitis is caused by organisms spreading through the blood stream from infection elsewhere in the body, it is called an  osteomyelitis of hematogenous origin. 

What are the symptoms of osteomyelitis?

The most common symptoms of osteomyelitis are pain in the affected part, fever and chills.  Other, more generalized symptoms, include nausea, loss of appetite, generalized weakness and/or a lack of energy.   Signs (observable findings) include redness and swelling of the infected area, drainage of pus, weight loss and excessive sweating at night (night sweats).   If you are experiencing these signs or symptoms and are concerned you may have osteomyelitis, consult your orthopedic surgeon for an evaluation.

Who is more likely to develop osteomyelitis?

Osteomyelitis can affect both children and adults.  However, there are several groups of individuals that have a greater risk for developing osteomyelitis due to various conditions affecting their health and natural defenses.  These groups include patients with diabetes, receiving hemodialysis, with sickle cell disease, using intravenous drugs illegally,  with weakened immune systems,  with advanced age (the elderly) and patients who have recently undergone a joint replacement surgery ( a total hip or a total knee arthroplasty).

Can osteomyelitis spread to other parts of the body?

Osteomyelitis does not usually spread to other parts of the body unless you have a health conditon that weakens your immune system or undergo a surgery where in a large surgical implant is used (i.e.; an artificial total joint or an artificial heart valve).   

How is osteomyelitis treated?

Acute osteomyelitis, of less than 4 weeks' duration, is usually treated successfully with antibiotics alone.   Before administering the antibitoics, your orthopedic surgeon will usually perform a needle aspiration or a biopsy to draw fluid or tissue from the infected bone for a culture.  The culture will determine what type of organism has caused the infection and which antibiotic will be most effective in treatment.  In the event that the bone infection is more severe or of longer duration than 4-6 weeks, surgery may be necessary to remove (debride) tissue that has become infected or that has lost its ability to defend itself (dead tissue).    Any gaps in the bone left after the debridement will then be filled with antibitoic beads that release and create extremely high concentratons of antibiotics in the wound and into the surrounding bone and soft tissues.   Systemic antibiotic treatment (intravenous or pills, by mouth) will usually be continued for several weeks following debridement surgery. 

In addition to the above, some other common methods of treatment for osteomyelitis and other bone infections include: free tissue transfers, external fixators, hyperbaric oxygen therapy, and, in some extreme cases, even an amputation.  The relative incidence of these methods used in the treatment of osteomyelitis will depend on the type and location of the infection, the health of the patient and the experience of the healthcare team.

Will osteomyelitis come back after treatment?

The formula for success when treating osteomyelitis is: 1) a complete and thorough removal (surgical debridement) of any and all of the dead or injured tissue within the wound; 2) administration of systemic and local antibiotics that are tailored, specifically, to the susceptibilities of the bacteria or fungi causing the infection; 3) providing stability to the affected bones and joints to prevent re-injury and, therefore, a source for re-infection; optimizing the host's response to both treatment and infection.  At the Osteomyelitis Treatment Center in San Diego, CA the long-term success rate for over 2,200 patients followed for two or more years is around 95%.