Osteomyelitis

Note: To read the complete article and not this abstract, please click here

Big Name, Big Infection

After noticing an increase in the numbers of IV drug users who have been diagnosed with osteomyelitis, BP thought some investigation was needed as it appears to be an infection most of us know very little about, but which can have some extremely serious consequences if left untreated. Osteomyelitis is a serious bone infection which can occur in virtually any bone in the body although it usually crops up in the spine, foot or in long tubular bones such as those in the arm or leg, even fingers.

osteomyelitis – an extremely painful infection inside the bone, and one that can affect injectors.

While quite rare in many countries, there has recently been a rise in the numbers of intravenous drug users (IVDUs) becoming infected and this is particularly disturbing considering its often vague initial signs and symptoms which can mean diagnosis is often delayed. This, coupled with the problems IVDUs often encounter when accessing health care can mean that many users are suffering unnecessarily through late diagnosis.

This is a particular concern as some forms of the disease, such as vertebral (spinal) osteomyelitis can, if left untreated, lead to permanent paralysis, significant spinal deformity or even death. It can be an extremely painful infection of the bone and can take some time to heal so it is important for all of us to be aware of osteomyelitis and its symptoms so we know what to look out for. People with compromised immune systems such as cancer or HIV/AIDS, need also be very aware of this debilitating condition as it is often more likely to appear in people whose immune systems are not functioning well.

What is it?

Osteomyelitis is usually a secondary infection that follows an infection borne elsewhere in the body – perhaps caused by a wound, (such as an infected abscess), surgery, bone fracture, or a foreign body such as a surgical plate. IV line, urinary catheter or bullet. Once started, the infection can then spread to the bone via the blood and when the bone is infected, pus is produced within the bone. This can result in an abscess, depriving the bone of its blood supply. Early treatment can save the bone from destruction but as bone is hard tissue it is often resistant to antibodies and this can be difficult to treat.

Similar to infective endocarditis (BP issue 7 and BP’s A-Z of Health), osteomyelitis is usually caused by the same bacteria: Staphylococcus aureus (Staph. a). This bacterium can be introduced into the body in a variety of ways. Staph a. live intermittently on the skin in more than 70% of the population at any one time and the other 14 are colonized persistently. Those who use injecting equipment on a regular basis and inject in sites that are potentially Staph A colonized such as the feet, hands, groin etc can be at greater risk of attracting infection (see prevention). Again, this is why a hygienic injecting regime is essential for all IV users to help reduce as many factors as possible that could encourage an infection, (see overleaf & BP no. 7).

To read the rest of this important article on osteomyelitis and catch up on the symptoms, treatment, its relation to intravenous drug use and more, click here (from BP issue 8)

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