My 7 yr old daughter has osteomylitis of the left index finger. It is swollen and sore and possibly from Mycobacteria. She is having debrement(sp?) surgery on Thurs and they will then get the biopsies and determine what anti-biotic to use. She had no cut or abrasion and wonder how she could have gotten this!! It has been this way for 2 1/2 months, but luckily is not in any other bones (bone scan). All her blood work has come back normal, except boarderline(?) Lyme Disease titer. Any ideas or experience??
Amy

Amy,
I have Osteomyelitis in my right tibia bone. I believe it was surgury when i had my knee fixed. The doctor's say it could have been cause from trauma to the bone from the screw they placed into the leg. It was a long time before they diagnosed the diease and alot of pain.Could your daughter have seriously hurt her finger without your knowlegde?? Hope her surgury works out.
Deb

My 12 year old was diagnosied with Tibial Osteomyelitis last April. All bllodwork was "within Normal" but MRI's showed the infection. They started IV antibiotics (two) and he was allergic to meds. The did a biopsy and never got a bug. They started two different meds but allergic to those. Lots of Benedryl held off reaction. Could not continue as long as doc would have liked, now it seems to be back. Bloodwork is slightly up. No trauma. No fracture, No surgery. No idea where this came from. Tired, fatigue, pain in leg everyday since February. I know what you are going through. I get copies of all reports and films and aask a lot of questions. Don't be afraid to do your homework, no one else is going to do it for you. Be active!

I have OM of the maxilla (jawbone). I am much better now however, I am going for HBO Hyperbaric Oxygen Therapy and having antibiotic beads placed right on the site and another PICC line because IV antibiotics are the only ones that work - and you have to find the right bug - the oral antibiotics are NOT concentrated enough to get to the bone. You must work closely with an infectious disease doctor and surgeon- because surgery is a must to eradicate this. Here is the protocol and some info on OM of the jaws:

Treatment Guideline for Acute or Chronic Osteomyelitis
Disrupt the infectious foci.
Debride any foreign bodies necrotic tissue, or sequestra.
Culture and identify specific pathogens for eventual definitive
antibiotic treatment.
Drain and irrigate the region.
Begin empiric antibiotics based on Gram stain.
Stabilize calcified tissue regionally.
Consider adjunctive treatments to enhance microvascular reperfusion
(usually reserved for refractory forms only).
Trephination
Decortication
Vascular flaps
Hyperbaric oxygen therapy
Reconstruction as necessary following resolution of the infection.

Osteomyelitis

The cause of osteomyelitis is associated with Staphylococcus aureus, a
skin surface bacterium. The organism is iatrogenically introduced
into the deeper tissue planes by surgery or trauma, resulting in an
infectious process that is either localized or hematogenously
metastatic or both. However, the idea of S aureus as the primary
pathogen of tooth-bearing bone does not hold true. Acute
osteomyelitis of the jaw is usually a polymicrobial disease, with
streptococci, Bacteroides, peptostreptococci, and other organisms
involved.

Hudson (1993) wrote that Acute osteomyelitis of the jaws may
manifest itself with fever, malaise, facial cellulitis, trismus, and
significant leukocytosis. Osteomyelitis of the jaws of a chronic
nature has findings consistent with swelling, pain, purulence,
intraoral or extraoral draining fistulae, and nonhealing bony and
overlying soft tissue wounds. Computerized tomography gives a more
definitive picture of the calcified tissue involvement, especially
with regard to disruption of the cortical plates. Diagnosis is based
on the presence of painful sequestra and suppurative areas of
tooth-bearing jaw bone unresponsive to debridement and conservative
therapy.

The goal of definitive therapy is to attenuate and eradicate the
proliferating pathogenic microorganisms and to support healing.
Pathogenic supportive debris should be removed and vascular
permeability to the infected area must be reestablished. This will
aid the host immune response in coming into contact with the offending
organisms.

There are 70+ types of mycobacteria. I believe I have mycobacterium marinum from the water in the inner harbor of baltimore. From the first biopsy it wasn't detected and now it has spread to the tendon of my left index finger. There is a huge problem in diagnosing this infection. It is because the bacteria doesn't grow at 37 degrees C, it grows at 30 degrees C. I had a small cut on my knuckle in October and the marinum infection started in December and has grown worse. I will get a second biopsy on 2/23/04 which will take 4 weeks to grow if anything growns. The xrays show nothing osteomylitis or swollen tendon. The doctors just don't want to take chances these days and won't prescribe minocyline. I wish they would.