Osteomyelitis is a bone infection. It is mainly caused by bacteria or other germs.
Bone infection is most often caused by bacteria. But it can also be caused by fungi or other germs. When a person has osteomyelitis:
In children, the long bones of the arms or legs are most often involved. In adults, the feet, spine bones (vertebrae), and hips (pelvis) are most commonly affected.
Risk factors are:
A physical exam shows bone tenderness and possible swelling and redness in the area around the bone.
Tests may include:
The goal of treatment is to get rid of the infection and reduce damage to the bone and surrounding tissues.
Antibiotics are given to destroy the bacteria causing the infection:
Surgery may be needed to remove dead bone tissue if the above methods fail:
Infection that occurs after joint replacement may require surgery. This is done to to remove the replaced joint and infected tissue in the area. A new prosthesis may be implanted in the same operation. More often, doctors wait until the infection has gone away.
If you have diabetes, it will need to be well controlled. If there are problems with blood supply to the infected area, such as the foot, surgery may be needed to improve blood flow and get rid of the infection.
With treatment, the outcome for acute osteomyelitis is often good.
The outlook is worse for those with long-term (chronic) osteomyelitis. Symptoms may come and go for years, even with surgery. Amputation may be needed, especially in people with diabetes or poor blood circulation.
The outlook for people with an infection of a prosthesis depends partly on:
Call your health care provider if you:
Berbari EF, Steckelberg JM, Osmon DR. Osteomyelitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 106.
Matteson EL, Osmon DR. Infections of bursae, joints, and bones. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 272.
Raukar NP, Zink BJ. Bone and joint infections. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 136.
Last reviewed on: 3/13/2016
Reviewed by: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.