Osteomyelitis: symptoms and treatment
Osteomyelitis is a disease not only of the bone, but of the whole organism. After all, when a purulent necrotic process caused by mycobacteria or bacteria that produce pus affects the bone marrow, the structural elements of the bone and surrounding tissues, the entire human body resists sepsis and reacts to it with inflammations.
What is this?
Bone osteomyelitis is their inflammation (as well as all tissues surrounding them), which is infectious in nature. In this case, the periosteum and bone marrow are affected, which swells, and the pus spreads through the blood vessels. In this case, the shells begin to press on the tissues, compress the blood vessels and stop the blood flow to the damaged tissue. This phenomenon is called sequestration, that is, necrosis. Sometimes a new bone, the so-called cover, begins to form on the site of necrosis. Osteomyelitis often affects the legs. Also, odontogenic osteomyelitis and post-traumatic osteomyelitis are «popular», in which a large number of road accidents are to blame.
The infection itself can get into the human body in two ways. Hematogenic osteomyelitis (also endogenous) arises from the ingress of microorganisms into the bone tissue with blood flow. Such osteomyelitis in children happens more often than in adults.
An infection can also get into the bone marrow as a result of traumas, for example, after open fractures, joint prosthetics or the setting of spokes. This is post-traumatic osteomyelitis. Also, inflammation can occur if the soft tissues that are located next to the bones are injured. If osteomyelitis is chronic, it can lead to deformity of bones and sclerotic phenomena. Osteomyelitis in children can lead to arthrosis and arthritis at an early age. Chronic osteomyelitis also leads to fistula formation.
Immediately it is necessary to say that the classification of osteomyelitis is not an easy matter, because every inflammation, alas, is individual. And yet, and acute osteomyelitis, both chronic and hematogenous occur due to bacteria. The most known pathogens of osteomyelitis are chronic bacteria such as Staphylococcus aureus (and other staphylococci, incidentally), Pseudomonas aeruginosa. It is also possible to get into the bone marrow anaerobic bacteria (for example, with diabetes and foot ulcer), gram-negative rods, whole groups of bacteria, tubercle bacillus, histoplasmosis, brucellosis, etc.
It should be noted that acute osteomyelitis often occurs as a result of hidden infections, allergies, lack of nutrients, with weak immunity and general asthenia.
«Start» the disease can also all kinds of injuries, frostbite and burns, colds, severe stress on the body and stressful situations.
Chronic osteomyelitis, as well as acute, can occur both generalized and locally, so symptoms may differ.
For a local form are typical:
- Deep pain and aches.
- The temperature is up to 38.5 (if osteomyelitis is chronic, then there may not be a high temperature).
- Elevations and swelling in a site that is damaged.
- Movements are painful and limited.
- The skin on the damaged area reddens and heats up.
- Pus is secreted through the skin.
- Abscesses occur.
In the generalized form, there are other symptoms:
- Pain becomes permanent and intensified.
- Body temperature is 39-40 degrees.
- Urination becomes painful and frequent.
- Possible damage to the nervous system (fainting, cramps, less often nonsense).
- General state of health worsens due to intoxication of the body.
- Skin pale.
- Thermoregulation disorders — chills, sweating.
If the disease is not noticed, then the acute form quickly flows into the chronic, so here as nowhere is important the diagnosis.
The diagnosis is based on the results of a microbiological study (bone biopsy, blood syringe, fistula, articular fluid), X-ray (although in the early stages it can not be detected with the help of the disease), computed tomography (helps to find gas in the bone marrow, and also Areas of dead tissue), fistulography, MRI, radionuclide diagnosis (suitable for the earliest diagnosis) and ultrasound.
The most common types of disease
Post-traumatic osteomyelitis can occur either after an open fracture, or during surgery on bone tissue or a joint. There is also a gunshot traumatic osteomyelitis, which often occurs after comminuted fractures.
Odontogenic osteomyelitis can arise as a result of bacteria penetrating through carious cavities, after dislocation of the jaw, periodontitis, improper treatment of the tooth or prosthetics, due to chronic diseases, and not only diseases of the oral cavity.
The acute form of this inflammatory disease is accompanied by pain in the area of the tooth, which is damaged. These sensations are amplified if the tooth is pressed or knocked. Also, there is swelling of the tissues around the affected tooth, they swell and blush. Over time, the tooth can become mobile, neighboring teeth too. Also become painful and enlarged lymphatic submandibular and cervical nodes. Headache in this case, too. Inflammation is also told by blood tests. With this inflammation, the taste sensations and the sensitivity of the lips are often violated.
Odontogenic osteomyelitis in chronic form can last for more than one year, with the pain that subsides, then again it makes itself known. Teeth become mobile at the same time, the bone thickens, and pus can periodically go pus. If a diagnosis is made of odontogenic osteomyelitis, treatment begins with the removal of the damaged tooth.
Acute hematogenous osteomyelitis occurs as a result of the introduction of bacteria that cause inflammation into the blood vessels of the bone. Acute hematogenous osteomyelitis is common in children. Usually, this inflammation affects long bones, but here the duration and nature of the course is different.
So, acute hematogenous osteomyelitis can last only two to three months, during which all the defenses of the body are activated and the inflammation goes by itself.
This is a breakdown form of the disease.
Also, hematogenous osteomyelitis can last about six months. Recovery also comes naturally, but this is a longer process.
In addition, acute hematogenous osteomyelitis can be fulminant. It is provoked by staphylococci. In this case, many degradation products of endogenous bacteria are instantly released into the blood, and the pressure instantaneously falls. In this case, acute hematogenous osteomyelitis can result in death.
It can also last more than eight months and become chronic. Complications can be a violation of protein metabolism and muscle atrophy.
Treatment of osteomyelitis without surgery will not be effective. But drug treatment should take place according to several principles.
First, you need to create a barrier that prevents bacteria from spreading.
Secondly, you need to choose the antibacterial drug to which the pathogen is sensitive.
And, finally, the medical treatment of osteomyelitis should be accompanied by a restriction of mobility of the problem area.
The operation is prescribed for frequent relapses, fistulas that last long, purulent swelling and severe necrosis.
Treatment of osteomyelitis with folk remedies is ineffective.