Osteomyelitis is a serious bone infection caused by bacteria or, less commonly, fungi. The infection can reach the bone through the bloodstream, from nearby tissue, or directly through open fractures, surgical wounds, or implants.



Most common causative agent:



Staphylococcus aureus, including MRSA

Other pathogens vary based on patient age, immune status, and infection route.



Types of osteomyelitis:



Acute – develops rapidly over days to weeks; more common in children



Chronic – persists for months or years; often involves necrotic bone, sinus tract formation, and relapsing infections



Hematogenous – via bloodstream, especially in long bones of children



Contiguous – from nearby tissue infection or trauma



Diabetic foot osteomyelitis – common in chronic wounds and ulcers in diabetic patients



Symptoms:



Deep, localized bone pain



Swelling, warmth, and redness over the affected area



Fever, chills, fatigue



Drainage from open wounds or fistulas (chronic cases)



Diagnosis includes:



Laboratory tests: elevated CRP, ESR, WBC



Imaging: X-ray (late changes), MRI (early detection), CT



Bone biopsy for culture and histology (gold standard)



Treatment:



IV antibiotics – usually 4–6 weeks, tailored to culture results



Surgical debridement – removal of necrotic bone



Chronic suppression therapy if full eradication isn’t possible



In severe cases: amputation or reconstruction



Early detection is key to avoiding permanent damage or systemic complications like sepsis.



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