Osteomyelitis is the local or generalized infection of bone and bone marrow, usually caused by bacteria. It can be introduced by trauma, surgery, by direct extension from a nearby infection or via the bloodstream.

Along with essential oxygen and nutrients, blood may also carry bacteria and other organisms which tend to settle in the capillaries of the long bones of the arms and legs. Infectious agents can also reach the bones directly from adjacent infected tissue or through an open wound or fracture. Osteomyelitis can attack more than one bone at a time.

It occurs in both children and adults, and is a serious infection that can be difficult to diagnose and treat.

Symptoms of Osteomyelitis
These may include pain and excruciating tenderness near a joint or at the affected area, accompanied by redness, swelling, a fever in the range of 102 F to 104 F, and chills.

Diagnosis of Osteomyelitis
In addition to taking a medical history and a physical exam, aspiration of the involved bone may be necessary.

Culture of the blood or bone tissue is essential for a precise diagnosis. Radiographs (x-rays) early in the course of the infection may be falsely negative. MRI (magnetic resonance imaging) may be more helpful in demonstrating the extent of soft tissue involved.

Treatment of Osteomyelitis
The treatment generally consists of surgical debridement of the infected bony and soft tissue structures, and the prolonged use of antibiotics. Until recently, these antibiotics have been given intravenously. Advances in oral antibiotic therapy have yielded newer agents that are able to penetrate into bone, and in many cases, are curative. This has markedly decreased the amount of hospitalization time needed for the osteomyelitis patient.

While oral agents may not have the same degree of success as intravenous antibiotics, certain elderly, debilitated or institutionalized patients might be ideal candidates for oral treatment. With either antibiotic regimen, however, complete surgical removal of the area is necessary to eradicate the infection.

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