Osteomyelitis - Symptoms and Causes

Overview

Osteomyelitis is a bone infection that can affect one or multiple parts of a bone. This infection happens in several ways:

Through the bloodstream
From nearby infected tissues
Directly into the bone through injuries

Risk factors include:

Smoking
Diabetes (especially with foot ulcers)
Chronic kidney failure

The condition is more common in people with diabetes who have foot ulcers, as the infection can spread to the bones in their feet.

Treatment typically involves two main approaches:

Surgical removal of infected bone tissue
Intravenous antibiotics following surgery

Most patients require both surgical intervention and strong antibiotics delivered directly into the bloodstream to effectively treat this bone infection.

Signs and Symptoms

The main signs of osteomyelitis include:

Swelling and warmth in the infected area
Tenderness when touching the affected bone
Pain around the infection site
Feeling tired or fatigued
Fever

Some people with osteomyelitis may not notice any symptoms. The symptoms can also look like other health problems. This is especially true for babies, elderly people, and those with weak immune systems.

When to Get Medical Help

Contact your healthcare provider if you have bone pain that worsens and is accompanied by fever.

If you have recently had surgery, an injury, or have a medical condition that increases your risk of infection, seek medical attention immediately if you notice any signs of infection.

Early treatment can prevent serious complications.

What Causes Bone Infections

Staphylococcus bacteria are the most common cause of bone infections (osteomyelitis). These bacteria naturally live on everyone’s skin and in their nose.

Bacteria can get into bones through several pathways. Blood circulation is one way germs travel. Infections in other body parts, such as pneumonia or bladder infections, can spread bacteria through the bloodstream to weak areas in bones.

Injuries provide another entry point for germs. When skin is punctured deeply, bacteria can enter the body and infect nearby bones. Broken bones that pierce through skin also allow germs direct access to bone tissue.

Surgical procedures create another risk. Operations to repair broken bones or replace joints can accidentally introduce bacteria into the body. These germs may then travel to bones and cause infection.

Risk Factors

Bones normally fight off infections well. However, as you age, this ability decreases. Several factors can raise your chance of getting bone infections:

Weakened Immune System

Poorly managed diabetes
Other conditions that reduce the body’s ability to fight infections

Blood Flow Problems

Peripheral artery disease (narrowed arteries to limbs)
Sickle cell disease (inherited condition affecting blood cells)

Medical Procedures

Dialysis and other treatments using medical tubes
These tubes can bring germs into the body

Skin Damage

Pressure injuries (sores from staying in one position)
These sores can allow bacteria to reach bones underneath

Drug Use

Using non-sterile needles
Not cleaning the skin before injection

People with limited mobility or sensation face higher risks of developing pressure sores that may lead to bone infections. When blood flow is reduced, the body struggles to deliver infection-fighting cells to affected areas.

Complications

Bone infections can lead to several serious problems if not treated properly.

Bone Death (Osteonecrosis): When infection blocks blood flow within the bone, parts of the bone tissue may die. Surgical removal of dead tissue is necessary before antibiotics can work effectively.
Joint Infection: The infection can spread from the bone into nearby joints, causing septic arthritis.
Growth Problems in Children: Children’s bones may not grow normally if infection affects the growth plates at the ends of arm and leg bones.
Chronic Infection: Some bone infections don’t respond well to treatment and become long-term problems. These persistent infections are harder to eliminate and may require extended treatment.

Prevention

Preventing osteomyelitis is especially important for people with higher infection risks. Taking steps to reduce your chance of getting infections can help protect your bones.

Wound Care

Proper wound care is essential for prevention:

Clean cuts and scrapes immediately with soap and water
Apply an antiseptic solution if available
Cover wounds with clean bandages
Check wounds regularly for signs of infection (redness, swelling, warmth, pain)

Risk Reduction

For those with increased infection risk:

Risk Factor	Prevention Strategy
Diabetes	Keep blood sugar controlled
Circulation problems	Inspect feet daily for injuries
Weakened immune system	Avoid high-risk environments when possible

Special Considerations

Children need supervision to avoid animal bites and scratches. Teach kids about proper wound cleaning and encourage them to tell adults about injuries.

People with medical devices like catheters should follow care instructions exactly. Proper handling helps prevent bacteria from entering the body.

If you notice signs of infection in any wound, seek medical attention promptly. Early treatment of skin infections can prevent bacteria from spreading to bones.