Osteomyelitis is an acute infectious disease characterized by purulent lesion of all bone structures – bone tissue (ostitis), periosteum (periostitis), bone marrow itself (periostitis). Osteomyelitis usually occurs as an acute disease, but it can take a chronic form.
reasons
The most important reason for the development of osteomyelitis is the penetration of microorganisms into the bone tissue and the development of an infectious process there. Infection can occur due to the hematogenic pathway, which is typical for infants and adolescents. Exogenous osteomyelitis develops as a result of ingestion of microorganisms from the external environment. The starting point is open bone fractures, gunshot wounds, surgical interventions with violation of asepsis and antiseptics.
Another type of osteomyelitis is contact osteomyelitis, which develops as a result of the aggravation and spread of the process from the affected soft tissues to the bone.
The main microorganisms that cause osteomyelitis are Staphylococcus and Streptococcus, Pseudomonas aeruginosa.
Also , hematogenous myelitis can cause the following diseases:
Angina (acute tonsillitis)
Otitis media (inflammation of the middle ear)
Pustular skin diseases, boils, carbuncles
Panaricius
Scarlet fever, measles, pneumonia, etc.
SYMPTOMS OF OSTEOMYELITIS
Since osteomyelitis in the early stages is almost not manifested by any symptoms, diagnosis can be quite difficult. The main symptoms can be divided into local and general clinics.
The general clinic may include intoxication syndrome caused by the presence of microorganisms in the cut. The patient gets chills, the body temperature rises to 40 degrees, tachycardia develops, malaise, body aches. This condition can easily be confused with an incipient acute respiratory infection. The condition lasts up to about 5 days, then local symptoms of osteomyelitis develop.
The patient complains of local pain at the site of the lesion, soft tissues are swollen and hyperemic. The mobility of soft tissues is limited. Osteomyelitis most often develops in the lower extremities, less often in the upper ones. In the rarest cases, there is a lesion of the ribs, spine, bones of the feet and hands. When the affected limb moves, sharp soreness appears. Exogenous osteomyelitis is accompanied by the presence of trauma, burns, open fracture, surgical intervention in the anamnesis.
Chronic osteomyelitis is accompanied by the same symptoms, but of a less intense nature, fistulas also appear – pathological passages-channels for pus to flow out.
DIAGNOSIS OF OSTEOMYELITIS
Laboratory tests – general clinical analysis of blood, urine, blood glucose, C-reactive protein
In the presence of a fistula – seeding of the separated for the determination of microorganisms, determination of sensitivity to antibiotics
X-ray examination
Computed tomography, magnetic resonance imaging, ultrasound, radionuclide diagnostics
TREATMENT OF OSTEOMYELITIS
All patients with osteomyelitis are hospitalized in a hospital in a traumatology or surgical department. Further treatment of such patients is carried out by two complex methods – conservative and surgical.
The conservative method includes active antibacterial therapy taking into account the sensitivity of the microorganism (ceftriaxone, gentamicin, lincomycin). Drug therapy is carried out for a long time, up to 4 weeks. Next, detoxification, plasmapheresis is carried out. Immunotherapy is prescribed – polyoxidonium and analogous drugs, probiotics. Medications are prescribed. Improving blood circulation – trental, pentoxifylline. In case of exogenous osteomyelitis, surgical treatment of the wound, antiseptic ointments and solutions are carried out.
Surgical treatment consists in surgical intervention – the site of inflammation is sanitized, necrotic areas are removed, and reconstructive operations are performed. During reconstructive operations, skin, bone and soft tissue defects are eliminated. One of the types of reconstructive operations is osteosynthesis.
