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    Aureus. It Can Be Either Acute or Chronic

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    fortunelobster
    Osteomyelitis is a bone infection, usually caused by Staphylococcus aureus bacteria. It can be acute, developing within 2 weeks of an infection or injury, sub-acute developing within 1-2 months, or chronic developing more than 2 months later. Risk factors include trauma, diabetes, drug use, and old age. Symptoms include pain, swelling, fever and drainage from the bone. Diagnosis involves blood tests and scans; treatment requires antibiotics and sometimes surgery to remove infected bone. Complications can include necrosis, bone abscesses, and reduced mobility.

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    Aureus. It Can Be Either Acute or Chronic

    Uploaded by

    fortunelobster
    541 views7 pages
    Osteomyelitis is a bone infection, usually caused by Staphylococcus aureus bacteria. It can be acute, developing within 2 weeks of an infection or injury, sub-acute developing within 1-2 months, or chronic developing more than 2 months later. Risk factors include trauma, diabetes, drug use, and old age. Symptoms include pain, swelling, fever and drainage from the bone. Diagnosis involves blood tests and scans; treatment requires antibiotics and sometimes surgery to remove infected bone. Complications can include necrosis, bone abscesses, and reduced mobility.

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    Osteomyelitis

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    Osteomyelitis is a bone infection, usually caused by Staphylococcus aureus bacteria. It can be acute, developing within 2 weeks of an infection or injury, sub-acute developing within 1-2 months, or chronic developing more than 2 months later. Risk factors include trauma, diabetes, drug use, and old age. Symptoms include pain, swelling, fever and drainage from the bone. Diagnosis involves blood tests and scans; treatment requires antibiotics and sometimes surgery to remove infected bone. Complications can include necrosis, bone abscesses, and reduced mobility.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    541 views7 pages

    Aureus. It Can Be Either Acute or Chronic

    Uploaded by

    fortunelobster
    Osteomyelitis is a bone infection, usually caused by Staphylococcus aureus bacteria. It can be acute, developing within 2 weeks of an infection or injury, sub-acute developing within 1-2 months, or chronic developing more than 2 months later. Risk factors include trauma, diabetes, drug use, and old age. Symptoms include pain, swelling, fever and drainage from the bone. Diagnosis involves blood tests and scans; treatment requires antibiotics and sometimes surgery to remove infected bone. Complications can include necrosis, bone abscesses, and reduced mobility.

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    of 7

    OSTEOMYELITIS

    Infection of the bone, most commonly caused by Staphylococcus


    Aureus. It can be either acute or chronic.

    OTHER NAME

    Hematogenous Osteomyelitis

    TYPES

    There are three main types of osteomyelitis:

    • Acute osteomyelitis - bone infection develops within two


    weeks of an initial infection, injury or the onset of an underlying
    disease.
    • Sub-acute osteomyelitis - bone infection develops within
    one or two months of an initial infection, injury or onset of an
    underlying disease.
    • Chronic osteomyelitis - bone infection develops two months
    or more after an initial infection, injury or onset of an underlying
    disease.

    CAUSES

    Bone infection can be caused by bacteria (more common) or fungi (less


    common).
    • Infection may spread to a bone from infected skin, muscles, or
    tendons next to the bone, as in osteomyelitis that occurs under a
    chronic skin ulcer (sore).
    • The infection that causes osteomyelitis can also start in another
    part of the body and spread to the bone through the blood.
    • A current or past injury may have made the affected bone more
    likely to develop the infection. A bone infection can also start after
    bone surgery, especially if the surgery is done after an injury or if
    metal rods or plates are placed in the bone.

    STAGES OF OSTEOMYELITIS
    RISK FACTORS

    • Trauma
    • Diabetes
    • Injected drug use
    • Hemodialysis
    • Old age
    - ↓Immune function
    • Poor circulation

    SIGNS AND SYMPTOMS

    • Pain and/or tenderness in the infected area


    • Swelling and warmth over the infected area
    • Fever
    • General discomfort, uneasiness, or ill feeling
    • Drainage of pus through the skin

    Additional symptoms that may be associated with this disease include:

    • Excessive sweating
    • Chills
    • Lower back pain (if the spine is involved)
    • Swelling of the ankles, feet, and legs
    • Changes in gait (walking pattern that is a painful, yielding a limp)

    PATHOPHYSIOLOGY

    Predisposing factors:
    • vascular insufficiency
    disorders
    • genitourinary infections
    • respiratory infections
    • IV drug use
    • Immune-compromising
    diseases
    • history of blood- stream

    Open
    wounds/fractures

    Microorganisms lodge into an


    area where circulation slows

    Microorganisms
    grow
    Increase
    pressure

    Ischemia Vascular
    compromise

    Infection through the


    bone cortex and

    Ischemia of the
    periosteum

    Cortical
    devascularization

    Necrosis

    Formation of new Sequestr Separation of


    bone devitalized
    bone from living bone

    Involucrum Continues to be an infected


    island

    Difficulty to reach by blood borne


    antibiotics

    Chronic Stage Enlarged


    sequestrum

    Development of sinus Sequestrum move


    tract out to the soft
    tissue

    Turns to scar Revascularize


    tissue d
    Site for continued Removal by the
    microorganism growth normal
    immune process

    Remission and Healing


    exacerbation
    Excessive
    Loss of organ Amputation
    vascular
    DIAGNOSTIC EXAM function
    insufficiency

    • CBC- WBC may be elevated (indicates presence of active infection).


    • ESR (erythrocyte sedimentation rate) - may be elevated (indicates
    inflammatory process).
    • Bone Scan (indicates infected bone).
    • Bone lesion biopsy or culture (may reveal the causative organism).
    • Needle aspiration of the area around affected bones
    • MRI of the bone

    TREATMENT AND MANAGEMENT


    The goal of treatment is to get rid of the infection and reduce damage to
    the bone and surrounding tissues.

    • Analgesics as prescribed.

    • Antibiotics as prescribes.

    • Dressing changes - use sterile technique.

    • Maintain proper body alignment and change position frequently to


    prevent deformities.

    • Immobilization of the affected part.


    Surgery may be needed to remove dead bone tissue if you have an
    infection that does not go away.

    • Incision and Drainage of bone abscess.

    • Sequestrectomy- removal of dead, infected bone and cartilage.

    • Bone grafting is recommended after repeated infections.


    If there are metal plates near the infection, they may need to be
    removed. The open space left by the removed bone tissue may be filled
    with bone graft or packing material that promotes the growth of new bone
    tissue.

    PREVENTION

    • Elective orthopedic surgery should be postponed if the patient has a


    current infection (like urinary tract infection, sore throat) or a recent
    history of infection.

    • During orthopedic surgery, careful attention is paid to the surgical


    environment and to techniques to decrease direct bone contamination.

    • Prophylactic antibiotics- administered to achieve adequate tissue


    levels at the time of surgery and for 24 hours after surgery.
    • Urinary catheters and drains are removed as soon as possible to
    decrease the incidence of hematogenous spread of infection.

    • Aseptic postoperative wound care reduces the incidence of superficial


    infections and osteomyelitis.

    • When patients who had joint replacement surgery undergo dental


    procedures or other invasive procedure, prophylactic antibiotic are
    frequently recommended.

    COMPLICATION

    • Necrosis
    • Blood clots
    • Sequestra (A piece of necrotic tissue, usually bone, which has become
    separated from the surrounding healthy tissue).
    • Bone abscess
    • Need for amputation
    • Reduced limb or joint function
    • Spread of infection to surrounding tissues or the bloodstream

    REFERENCES:

    1. Brunner and Suddarth’s Textbook of Medical Surgical Nursing pp.


    2064-2067

    2. Professional Guide to Diseases (Eighth Edition), 2005

    3. http://www.nlm.nih.gov/medlineplus/ency/article/000437.htm

    4. http://www.wrongdiagnosis.com/o/osteomyelitis/intro.htm

    ILLUSTRATION

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