By: Pallavi Vathiar. Practicing Clinical Nutritionist, Mumbai.
Osteomyelitis is a bacterial, or fungal, infection of the bone. It can happen if a bacterial or fungal infection enters the bone tissue from the bloodstream, due to injury or surgery. When this happens, it can lead to the eventual death of the bone tissue.
Osteomyelitis affects about 2 out of every 10,000 people. It can affect both adults and children. In adults, Osteomyelitis often affects the vertebrae and the pelvis. In children, Osteomyelitis usually affects the adjacent ends of long bones (bones in the arms or legs) (1).
Who Are At Risk Of Getting Osteomyelitis?
- People with diabetes, HIV, kidney diesease.
- Patients receiving haemo-dialysis.
- People with weak immune systems.
- People with sickle cell disease.
- Intravenous drug abusers and smokers.
- The elderly and senior citizens.
Osteomyelitis of Fibula Rare Case with Various Differential Diagnosis.
A 65-year-male operated 10 years back for tibial plateau fracture was asymptomatic but for last 3 months started pus discharging sinus from middle third of leg. Investigation and implant removal was done with abnormal tissue abnormal bone was excised out, but very unusual presentation intra-operative necrotic massive debris was there like wood pieces mimic as neoplastic lesion, metastasis, fungal osteomyelitis, or granulomatous infection. However, after biopsy, it was diagnosed pyogenic osteomyelitis 2 weeks of injectable and 6 weeks of oral antibiotics were given. After that 4-6 weeks weight bearing was started, the patient returned to his obvious activities with normal range of motion.
The osteomyelitis of fibula with various differential diagnosis clinically and intraoperatively with very rare necrotic tissues like wood pieces mimicked neoplasia fungal infection but after proper debridement curettage and biopsy report probable diagnosis is made with proper duration of antibiotic treatment chronic osteomyelitis was treated with satisfactory result with good outcome (3).
Immediate treatment is indicated for osteomyelitis, especially in the acute phase. A bone biopsy diagnoses what type of germ is causing the infection. An antibiotic that works well against that type of infection is then selected.
Interestingly a 2019 study on the history of osteomyelitis treatment concluded – “Although antibiotic treatment of osteomyelitis has significantly advanced over the last 80 years, standard approaches to treatment of the condition do not appear to have an extensive evidentiary basis (4).”
Complications Of Osteomyelitis (5)
Although osteomyelitis is usually treated successfully, chronic and severe cases can lead to other problems.
Underlying conditions that are often the cause of osteomyelitis, such as poor circulation or a weakened immune system, can be difficult to treat. Therefore, if you have had a previous episode of osteomyelitis, there is a chance of it returning.
Amputation is used as a last resort for treating chronic osteomyelitis if the blood supply to bones is severely reduced.
With a reduced blood supply, the bones receive fewer infection-fighting blood cells. This means the infection may spread beyond the bone and into the surrounding soft tissue. The tissue will then begin to die, which is known as Gangrene.
Once gangrene develops, it may be necessary to amputate the affected limb to prevent the spread of infection and prevent further damage to healthy tissue.
It is not always possible to prevent Osteomyelitis, but there are steps you can take to reduce your chances of developing the condition
You can reduce your chances of getting an infection from an injury by ensuring that wounds are cleaned thoroughly.
Improving your health
You may be at a high risk of osteomyelitis if you have a weakened immune system or poor circulation. Taking steps to improve your general health can reduce your risk of osteomyelitis.
If you smoke, it is strongly recommended you quit as soon as possible as it will weaken the immune system hence recovery speed too.
High fat foods can cause a build-up of fatty deposits in your arteries, and being overweight can lead to high blood pressure.
To improve your circulation, a low-fat high-fibre diet is recommended, including plenty of fresh fruit and vegetables (at least five portions a day) and wholegrains.
Managing Your Weight
If you are overweight or obese, try to lose weight and then maintain a healthy weight by using a combination of a calorie-controlled diet and regular exercise.
If you drink alcohol, don’t exceed the recommended daily limits. These are:
- 2 servings a day for men.
- 1 serving a day for women.
- A small glass of wine or a single measure (25 ml) of spirits.
Contact your doctor if you are finding it difficult to moderate your drinking.
For most people, 150 minutes of moderate to vigorous exercise a week is recommended. However, if your overall health is poor, it may be necessary for you to exercise using a programme tailored specifically to your current needs and fitness level.