1. Osteomyelitis
Stephanie Licano

2. What is Osteomyelitis?
A local or generalized infection of bone and bone marrow
can be usefully subclassifed on the basis of the causative organism, the route, duration and anatomic location of the infection.

3. Causes…... Bacteria is most often introduced through trauma
The bacteria can also travel from one site of the body to the bone causing infection
Staphylococcus aureus is also the most common organism seen in osteomyelitis
Trauma: Compound fracture or surgery ie: joint replacements or internal fixation of fractures
Bacteria: invades the bone and then degeneration occurs

4. Occurs invariably in children, usually in the long bones
Also in adults it may be because of compromised host resistance due to debilitation, intravenous drug abuse, disease or drugs (e.g. immunosuppressive therapy).

5. You might want to check for…
Abrupt onset of high fever
Irritability
Malaise
Restriction of movement
Local edema, erythema, and tenderness
Non-healing ulcer
Chronic fatigue
Sinus tract drainage
(fever is present in only 50% of neonates with osteomyelitis)

6. Tests CBC: The WBC count may be elevated, but it frequently is normal
Radiology
MRI
Ultrasound
CT scanning
Radionuclide bone scanning
osteomyelitis, culture or aspiration findings in samples of the infected site are normal in 25% of cases. Blood culture results are positive in only 50% of patients with hematogenous osteomyelitis.

7. Diagnosis requires 2 of the 4 following criteria:
Purulent material on aspiration of affected bone
Positive findings of bone tissue or blood culture
Localized classic physical findings of bony tenderness, with overlying soft-tissue erythema or edema
Positive radiological imaging study

8. Treatment Osteomyelitis often requires prolonged antibiotic therapy
Severe cases may lead to the loss of a limb. Initial first line antibiotic choice is determined by the patient's history and regional differences in common infective organisms.
Surgical debridement
Antibiotic: can last for several weeks or months
Such as cephalothin (Keflin) and ancef

9. Some Nursing Interventions…
Use gentleness while moving the patient
Rest of the affected part is completely necessary
Use of pillows and sandbags for good alignment
Wounds are irrigated with hydrogen peroxide, or another antiseptic or antibiotic solution then covered using strict medical asepsis
Patients are placed on drainage and secretion precautions
PAIN IS EXTREMELY SEVERE!!!!!!
Also diet is high in calories, protein, and vitamins

10. Patient Teaching
The patient should be taught about signs of infection, like an elevated temperature
It is also important for the patient to be aware of the recurrence of signs and symptoms
Patients should be told to avoid trauma to the affected bone because fractures are common

11. Complications Bone abscess Bacteremia Fracture
Loosening of the prosthetic implant
Overlying soft-tissue cellulitis
Draining soft-tissue sinus tracts

12. Prognosis
Acute osteomyelitis may respond to treatment after several weeks.
Chronic osteomyelitis may persist for years with exacerbations and remissions