Chronic osteomyelitis

Most chronic osteomyelitis results from improper or delayed treatment of acute osteomyelitis. However, if the acute pathogen is low-virulence or the patient's resistance is strong, it may start as subacute or chronic; osteomyelitis from skin wound infection often starts chronic. The pathogen is mainly pyogenic Staphylococcus aureus; chronic sinus often has mixed infection. It favors the long-bone metaphysis in children. Most have a history of acute osteomyelitis, open fracture infection, recurrent acute inflammation, long-standing purulent sinus discharge and sequestra discharged through the sinus. Clinically it is characterized by purulent sinus discharge, sequestra and dead space, and limb deformity.

Common Symptoms

Acute pyogenic hand infection; bone marrow damage; low fever; skull hyperplasia

Causes

With timely active treatment in the acute phase most cases are cured, but many still develop chronic osteomyelitis, commonly due to: sequestrum formation; large sequestra are not absorbed and act as foreign bodies and bacterial foci, and the presence of sequestra, foreign bodies such as shell fragments and dead space causes surrounding inflammation and new bone hyperplasia forming an involucrum, so bone becomes thick and rough; a sinus may not heal for years, and poor drainage causes systemic symptoms. Extensive local scarring and sinus formation with poor circulation favor bacterial growth, while antibiotics cannot reach the area, causing chronic osteomyelitis. If bacterial virulence is low or resistance strong, the abscess is enclosed within bone as a localized intraosseous abscess called Brodie's abscess, usually at the upper or lower tibia, often asymptomatic initially with local redness, swelling and pain only months or years later; if the lesion shows extensive hyperostosis obliterating the medullary cavity with poor circulation, solid diffuse osteomyelitis called sclerosing osteomyelitis of Garre results, most often in the femur and tibia, mainly with intermittent pain. After acute symptoms subside and general condition improves, the lesion persists and becomes chronic; failure of timely proper acute treatment leaves many sequestra, causing chronic osteomyelitis.

Treatment

Medication, supportive treatment

Prevention

Specifically, eat regularly, keep regular hours and exercise moderately. Note: 1. During colds and fever, temperature should not exceed 38.5 degrees; promptly use antibacterial, anti-inflammatory and antipyretic injections IV or IM, or heat-clearing Chinese medicine, to nip bacteria that could cause osteomyelitis in the bud. 2. When trauma fractures, bruises or postoperative infections, bedsores etc. flare up, treat them timely and accurately to control further bacterial invasion; use high-dose anti-infective, antiviral and anti-inflammatory IV drugs (or Chinese medicine) to expel or disperse the infection early. 3. In daily life avoid overwork; overwork lowers resistance and immunity, letting bacteria invade and cause osteomyelitis. 4. When treating other diseases, do not abuse or long-term use hormonal drugs; improper use accelerates bone and medullary sclerosis and obstruction, impairing osteocyte metabolism and even causing bone necrosis.

Recommended Department

It is recommended to visit the orthopedic surgery department; before the visit you may first book an appointment and connect with experts through this platform.

Warm reminder: The above information is provided for health education reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek care at a regular hospital in time.