Bone infections may occur in any bone. However, there is a predisposition for the long bones. Bone infections are usually caused by bacteria, but may be due to fungi or parasites. These micro-organisms gain entry to the bone both directly or indirectly via blood. Bone infections may be acute or chronic.
Bone Infections Drugs
- Benzyl penicillin
- Fusidic acid
Bone Infections Symptoms
The symptoms of bone infections vary according to the site of infection and the age of the affected person. In the aged and those who are immune-suppressed symptoms may be mild and, as a result, are often missed. Below you will find some of the symptoms of bone infections.
Symptoms in infants include:
- failure to thrive
- loss of appetite
- resistance to limb movement.
- excruciating pain on the affected limb
- refusal to bear weight on the limb
- refusal to play
- local swelling
- swollen lymph nodes
Symptoms in adults include:
Bone Infections Causes
Bone infections arise when microorganisms gain access to the bone, multiply and result in clinical signs and symptoms. These microorganisms include:
- bacteria, such as Staphylococcus aureus, Streptococcus pyogenes
- parasites, such as hydatid
These microorganisms seed in the bone through various routes:
- they may be introduced directly via the skin through a stab wound, open fracture or injection;
- from direct spread from nearby foci of infection;
- or indirectly through blood from a distant site of infection such as the throat, bowel
Factors that increase the predisposition to bone infection are diabetes, immunosuppressive drugs, trauma, malnutrition, immune deficiency and general debilitating conditions.
Bone Infections Diagnosis
The diagnosis of bone infection is primarily based on the presenting clinical signs and symptoms. However both radiographic imaging and laboratory investigations may be employed to confirm the diagnosis. Examples of diagnostic imaging used are:
- Plain X-ray
- Radionuclide scanning
- Magnetic Resonance Imaging (MRI)
Laboratory investigations use a sample of fluid or pus aspirated from the bone abscess and examining under the microscope to visualize the causative micro-organisms. The sample is also tested for drug sensitivity. In addition, a blood sample is taken to detect a rise in inflammatory markers such as white blood cells, C-reactive protein and Erythrocyte Sedimentation Rate.
Bone Infections Treatment
The treatment of bone infection entails the following fundamental aspects:
- Providing adequate pain relief and rehydration. This is accomplished by administering analgesics such as paracetamol, diclofenac, morphine and fluids as deemed necessary
- Elevating and splinting the affected limb to achieve comfort and prevent contractures and dislocations. This may be achieved by skin traction of use of a plaster slab
- Prompt administration of antibiotics within the two days of onset of symptoms, such as Cefotaxime, Flucloxacillin, Benzylpenicillin, Gentamicin, Cefuroxime, Fusidic acid, Chloramphenicol or Vancomycin
- Surgical drainage is recommended if there is no resolution of symptoms 36 hours after initiating antibiotics or if there’s evidence of deep pus.