Osteomyelitis Flashcards
Osteomyelitis
Severe infection of the bone, marrow, and surrounding soft tissue
OM: Most common infecting organism
Staphylococcus aureus
Is OM easy to cure?
NO!
-Extraordinarily difficult to cure
Delayed identification of OM can lead to?
- Chronic pain, infection, & drainage
- Loss of function
- Amputation
- Death
Factors that INCREASE likelihood of OM
- IV drug use
- Diabetes
- Immunosuppression
- Hx of blood infections
- Presence of pressure ulcers/chronic open wounds
- Limiting spread is complicated by:
- Malnutrition
- Alcoholism
- Liver failure
How does the bacteria gain entry?
Indirect: Blood Stream
Direct: Open Wound/Direct Entry
Acute Osteomyelitis: Duration
< 1 month in duration
Chronic Osteomyelitis: Duration
> 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
Acute Osteomyelitis: LOCAL Manifestations
- Constant bone pain that worsens with activity/unrelieved by rest
- Swelling, tenderness, & warmth at infection site
- Restricted movement of affected part
Acute Osteomyelitis: SYSTEMIC Manifestations
- Fever + chills
- Night sweats
- Restlessness
- Nausea
- Malaise
Chronic Osteomyelitis: LOCAL Manifestations
*Local manifestations are more common
- Constant bone pain
- Swelling
- Warmth at site
Chronic Osteomyelitis: SYSTEMIC Manifestations
Systemic manifestations are REDUCED with chronic OM
OM Diagnostics
- Bone/tissue biopsy (to determine causative organism)
- Blood & Wound culture (+)
- ↑ WBC/ ↑ ESR
- X-ray (results do NOT show changes until 10 days after infection) ☢
***5. Radionuclide bone scans (preferred)
- MRI
OM: Collaborative Care
◉Vigorous/prolonged IV antibiotics (PICC line)
◉Surgical debridement
◉Some immobilization of affected limb; initially may be on bedrest
◉Pain control
