Forms and methods of treatment of osteomyelitis in children and adults


1. causes of the disease and its types

2. clinical picture of osteomyelitis

3. Osteomyelitis in Children

4. Treatment of diseases

Osteomyelitis - an infectious disease of the bone, the periosteum and bone marrow, accompanied by inflammation, suppuration, and in severe cases, necrosis of the affected area.

causes of the disease and its types

reason osteomyelitis - penetration of pathogens into the bone directly through the lesion (traumatic osteomyelitis), or through the bloodstream (hematogenous osteomyelitis).

The majority of patients (approximately 80%) disease is caused by staphylococci, the rest (15-20%) - streptococci and pneumococci.Only in some cases, the causative agent of osteomyelitis are E. coli, microscopic fungi, Proteus, or other microorganisms.

Traumatic bone osteomyelitis may occur after all sorts of injuries (open fractures, gunshot wounds, etc.).Hematogenous osteomyelitis is congenital or acquired internal infection, most often it is diagnosed in n

ewborns and older children (mostly boys).The infection is found in the blood as a result of abscesses, boils, purulent tonsillitis, carious teeth, tonsillitis and other infectious diseases, and provokes osteomyelitis in children and adults.Purulent infection affects not only bone, but the bone marrow and leads to its irreversible destructive changes.

each of the aforementioned types of diseases characterized by a form of: acute or chronic.The acute form of the disease is observed in the beginning of the inflammatory process in the absence of a competent treatment becomes chronic osteomyelitis bone.

clinical picture of osteomyelitis

Acute hematogenous osteomyelitis lasts no more than four weeks, but to detect it earlier than two weeks after the appearance is almost impossible.

Symptoms of acute osteomyelitis following:

  • spontaneous, aching pain in the limbs, which soon becomes a sharp, bursting or boring character and prevents normal movement of the limbs
  • increased body temperature (up to 39 ° C and above)
  • uncertaintyconsciousness, malaise, nausea, vomiting, weakness, lack of
  • appetite decreases blood pressure, the person turns pale, the skin becomes dry, the mucous membranes become bluish tint
  • palpation of the liver area, spleen, kidney, felt pain, authorities increased
  • observed swellingand redness of the affected area, visible veins, enlarged regional lymph nodes
  • in the blood increases the level of white blood cells, neutrophils, increased erythrocyte sedimentation rate indicator.

The disease usually develops very quickly, all of the above symptoms of bone osteomyelitis can manifest itself just 1-2 days.

If treatment is delayed osteomyelitis, abscess is formed intra-muscular (ie purulent inflammation spreads to nearby cells).Although in this case the patient's condition slightly improved, the need for surgical intervention is required.Upon further tightening of the treatment of osteomyelitis may cause purulent arthritis, and even sepsis (blood poisoning).

Symptoms of traumatic osteomyelitis bone are the same as the above symptoms hematogenous osteomyelitis.The only nuance - with traumatic osteomyelitis of the presence of an open injury makes it possible to watch the whole "picture" of the disease.

In the absence of a competent treatment of osteomyelitis, or when its lack of effectiveness, an acute form of the disease becomes chronic.Osteomyelitis Chronic develops after 2-3 months from the beginning of the acute form of the disease and is characterized by ongoing necrosis of the affected bone.

and traumatic, and hematogenous chronic osteomyelitis manifests itself as follows:

  • despite the painful loss of a limb and swelling, the patient's condition improves, reduced body temperature
  • affected area covered with gray bloom, from the wound out pus (only ifopen wound, that is, only in traumatic osteomyelitis)
  • observed the destruction of bone and, as a consequence,
  • joint deformation can be muscle atrophy, and prolonged course of chronic osteomyelitis there is a possibility of shortening the patient limb
  • disturbed metabolism, which leads to failuredifferent organs

diagnose chronic osteomyelitis can be based on X-ray and laboratory tests, and only after, when the treatment of the acute form of the disease has not produced the desired effect.

Osteomyelitis in Children

most commonly diagnosed in children is acute hematogenous osteomyelitis (90%).And usually, the disease affects the bone marrow is first, and then the bone and periosteum.

feature of osteomyelitis in children is that sometimes it is difficult to diagnose.The smaller the baby, the more difficult to diagnose.Often the only symptom of disease in children under 1 year - anxiety of the child and the immobility of a limb.

The older the children are developing "adult" symptoms.

Osteomyelitis in children usually occurs in one of three forms:

1. Local Form easiest and is characterized by a satisfactory general condition of the child, increased body temperature, not the strong intoxication.After some simple procedures for opening an abscess the patient's condition improves.

2. septic piemicheskaya form bone osteomyelitis is inherent in almost half of the sick children.It is characterized by a very high body temperature, feeling sick baby, nausea, vomiting, headache.The limb swells, reddens and hurts badly.

3. The toxic form is very rare (1-3% of all patients).Reduced temperature, blood pressure falls.In this form of osteomyelitis in children often occurs death.

Children carry heavy osteomyelitis.If your baby is observed weakly pronounced nausea, headache, but the child complains of pain in the limbs, and you see that it is (of course) was swollen and reddened, immediately contact your doctor.According to test results, according to X-ray and ultrasound, the doctor will be able to confirm or refute the diagnosis of "osteomyelitis".

Treatment of diseases

Conservative treatment of osteomyelitis is carried out in three directions:

  • infection, the pathogen must be withdrawn from the body.Drugs that are well established in the fight against pathogens of osteomyelitis bone - antibiotics, namely fuzidin-, kefzol, lincomycin, gentamicin.Other types of antibiotics (including penicillin) are ineffective in the treatment of osteomyelitis.In addition, a powerful therapy aimed at eliminating intoxication (hemosorbtion, plasma transfusion, hyperbaric oxygenation)
  • should be carried out local treatment of the affected area.Recommended physiotherapy and superimposition of plaster splints on his injured limb
  • And the third direction in the treatment of osteomyelitis - increase the body's resistance to various infections.The patient shows vitamins and stimulators of the immune system.

also possible surgical treatment of osteomyelitis bone.In the early stages of the disease is carried out bone trepanation with subsequent drainage installation.In case of formation of cellulitis surgery includes purged pus, washing, removal of the fistula may even removing diseased focus.

Osteomyelitis - very serious illness, do not neglect its treatment.It is important to remember that the earlier the diagnosis, the more successful the treatment will take place osteomyelitis.In case of delayed treatment to the doctor the effects of the disease can be very negative, even lethal.


This article is available exclusively in the educational purposes and is not research material or professional medical advice.

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