Wednesday, October 12, 2011

Osteo - it is everywhere

It isn’t uncommon for me to see a patient with osteomyelitis everyday.  Osteo (as we call it) is a bacterial infection of the bone, which is very difficult to treat and cure.  It usually comes up as a result of a small infection of the skin which goes untreated and goes deeper into the muscle and then into the bone.  Sometimes it happens from trauma to an extremity and introduction of bacteria into deeper tissue, which goes undetected and results in an infection of the bone.  This doesn’t come up overnight, but takes days and weeks to form – so you would like to think we could stop infections  from progressing to osteo, but rarely do we succeed.

I have seen osteo in almost all bones – arms, legs, fingers, toes, ribs, clavicles, vertebra and mandibles (face).  I guess I haven’t seen it of the skull, sternum and sacrum, but most everywhere else.  Today though I saw something I hadn’t seen before – osteo  (or near osteo) of 4 extremities at the same time.  A little girl was brought into clinic about 2 wks ago and had swelling of her right ankle, and R arm and xray findings were clear that she had already established osteo of her tibia and her humerus.  I put her on antibiotics and today saw her in followup.  Now her left thigh was about 3 times the size of her right, full of pus, and her left shoulder had an abscess on it.  She might not have osteo right now of her left femur and her left shoulder – but I guarantee you with all the pus she had in her leg and arm that I drained – we are too late and she is going to develop it. 

Unfortunately, this isn’t good for this little girl – as osteo often causes significant pain and destruction to the bones that are involved.  Having one extremity affected is often manageable, but to have all of them, she doesn’t have a good arm or leg left – not good.  She is currently pretty sick, so pray for her to respond to the antibiotics and for the infection that is throughout her whole body now to go down.