Osteomyelitis meaning – chronic refractory osteomyelitis is a persistent or recurring bone infection that lasts longer than six months even after treatment that included debridement and antibiotics. Osteomyelitis is classified into 3 categories:
- Bone infection that has spread through the bloodstream (called Hematogenous osteomyelitis)
- Osteomyelitis caused by bacteria that gains entry into the bone through an injury in a close by area of the body.
- Osteomyelitis that is a result of diabetic foot infection or any other reason which causes reduced supply of oxygen to the bones.
Osteomyelitis is usually caused by Staphylococcus bacteria. The blood infections are commonly due to staphylococcus aureus, streptococcus species and aerobic gram-negative bacilli. Bodies of patients with compromised immune systems fail to fight back the bacteria letting it reach the bones ultimately.
Symptoms of Osteomyelitis
- As a result of infection, body may run a fever
- Severe pain and tenderness in the affected area
- Inflammation at the site of infection
- Inability to move joints (if they are infected)
- Difficulty in walking or carrying weights
- Limping or stiff back may be symptoms when the bones in the hip are affected.
There are plenty of other conditions that can show the very same symptoms. In order to determine the root cause, your doctor may ask for some blood tests to be done along with some imaging tests.
Diagnosis of Osteomyelitis
A blood test will be the first one to be asked for. A higher than usual count of white blood cells would indicate an infection in the body. If you are feeling pain and tenderness in different parts of the body, imaging tests such as X ray, CT Scan or MRI may be taken to see if anything is not right with the bones. These usually gives your doctor a fair idea about the infection. Bone aspirations or biopsy may be done.
Treatment of Osteomyelitis
The treatment for osteomyelitis aims at removing the infection from the body. This can include debridement and administering antibiotics, preferably through IV. You may have to stay in the hospital from a few days to weeks. Antibiotics may be prescribed even after the complete remission, just in case if there may be a relapse of the infection. The drawback of conventional usage of antibiotics to treat osteomyelitis is that it is relatively difficult to treat due to the relative paucity of blood vessels in the bone and the antibiotics can’t penetrate the bone wall to kill the infection. If the infection affects the bone in the spine, skull or sternum, the odds of the patient’s survival goes down.
How does HBOT help in treating osteomyelitis?
HBOT, hyperbaric oxygen therapy involves supplying the patient with 100% medical grade oxygen in a closed chamber at a pressure that is usually twice or thrice the normal atmospheric pressure. The session can last from 60 to 90 minutes depending on the patient’s need. When pure oxygen is supplied to the body at higher pressure, more oxygen gets dissolved in the blood (red blood cells and the plasma) and is carried to every cell of the body even to those who are short of blood supply.
In the case of treating osteomyelitis, HBOT improves the penetration of antibiotics into the bone and stimulates osteogenesis. It has been noted that when the bones are infected, they are supplied with quite less amounts of oxygen than required. HBOT increases the supply of oxygen to the bones that helps in killing the gram-positive and some gram-negative microbes in the body. It also helps in moving more amounts of antibiotics to the bones and to the infected area effectively cleaning the infection and preventing recurrence.