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Osteomyelitis

Osteomyelitis

Osteomyelitis : You may not have heard of it, but osteomyelitis is one of the most frequent foot infections in diabetics, accounting for 10-15% of mild infections and nearly 50% of severe infections. Osteomyelitis is an infection of the bone that is caused by a variety of microbes — most notably staphylococcus aureus. This infection affects roughly two out of every 10,000 people, and is especially prevalent among diabetics, sickle cell anemics, dialysis patients, drug users, the elderly, and people with weakened immune systems.

How Do People Get Osteomyelitis?

There are many ways a person’s bone can become infected, such as:

  • An open fracture, where the bone pierces the skin (evident in 47% of all cases)
  • Pneumonia or a urinary tract infection turns septic and gets into the bloodstream
  • Vascular insufficiency (which is especially a concern for diabetics)
  • A puncture wound that doesn’t heal right (1-6% cases)
  • A minor wound, which leads to blood clotting around the bone and infection
  • A minor wound, which leads to blood clotting around the bone and infection

Symptoms of Osteomyelitis Early symptoms include pain, tenderness, swelling, warmth, and fever. Many people become nauseous, uneasy, and generally ill-feeling. Sometimes pus drainage through the skin is visible. Excessive sweating, chills, swelling of the lower extremities, and limping have also been reported alongside osteomyelitis. A diagnosis can be made by a physician who will look for signs of tenderness and likely order blood tests/cultures. Other diagnostic indicators include needle aspiration, biopsies, and bone scans.

Treatment of Osteomyelitis Until fairly recently, the standard treatment for diabetic foot osteomyelitis was to scrape away infected portions of the bone during the open surgical procedure. However, more doctors are using antibiotics as a first course treatment to cause remission. The antibiotics rid the body of harmful bacteria in the bloodstream that may otherwise re-infect the bone. Aspiration (draining of infection using a needle) and biopsy sampling will ensure you are given the proper type and dose of antibiotics. Splinting or casting may be required to immobilize the infected bone and avoid further injury. In some cases, surgery is still required, but the prognosis is very good when using a combination of surgery and antibiotics. Very rare cases of chronic osteomyelitis may lead to foot amputation or squamous-cell skin cancer. Though rare, prompt medical attention is important when diabetics encounter any signs or symptoms of infection.

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