Osteomyelitis - Bone Disorders Message Board

tr · 09-24-2003, 06:47 AM

My father is 78 and was diagnosed in June 03 with osteomyelitis in his foot/ankle. He was admitted for 8 weeks with IV antibiotics. Has been home but still having pain in the foot. Another MRI was done this past Monday and he was readmitted to the hospital stating he still had the osteo. They are sending him home with only oral antibiotics only two days after admitting him. I am assuming this is a chronic infection but am wondering if they are making the correct decision to send him home on only oral antibiotics. His circulation is not good (but not a diabetic) and also has dementia. Is this the correct decision for his care? Help

lostsoul15204 · 09-24-2003, 05:10 PM

tr, I have had vertebral osteomyelitis since 6-02 and I have had 2 pic lines with different antibiotics. Mine is cronic and after 9 mo.s on antibiotics they have stopped them so as I don't become immune, I guess, Sorry to hear about your dad, mine is caused by strep infection which is harder to get rid of than staph Good luck and GOD bless

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Rick

tryingtofeelgood · 10-02-2003, 03:42 PM

Sorry to hear about all the pain. Your father needs a good infectious disease doctor. Does he have diabetes? Ulcers, hotness, redness, swelling in the area? Did they take a culture to see which antibiotic would work?

I have OM of the maxilla. I am much better, but here's what the standard treatment is - you have to do all of this - a bone infection is very hard to cure. I have been battling it for a year, which in OM time is pretty short. get back on IV antibiotics as soon as you can. They need to grow your bugs and then the ID doctor will tell you which is the best med to treat it with. I hope you are not in much pain, if any. I have a lot. PLEASE also consider the HBO Hyperbaric Oxygen Therapy as an adjunct. It helps in healing. What happened with how your father contracted it?
PROTOCOL FOR TREATING OSTEOMYELITIS:

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.

GeneF · 03-08-2005, 02:21 PM

My fater (89) broke his left Tibia in December 04. And was diagnosed with Osteoperosis at that time. Treatment was a brace from thigh to ankle with a boot for the foot as support, and he was to stay in bed. We were not to remove the brace.

In 6 weeks, he developed blisters on both heels which required surgery as they went all the way to his bone.

The surgeon called in an infectious disease specialist who started a regimine of Antibiorics IV as she diagnosed Osteomyelitis.

Long story short is that now after 6 weeks of antibiotics and a mediport being placed in his chest as he continuously pulled out his IV's, he has been sent home with Hospice care only. No Antibiotics, no wound vac, not nothing.

My question is what can we expect as to the progression if this infection to it's ultimate end. He has several other medical issues including suspected, but not officially diagnosed CHD. He has had a pacemaker for 7 years and it fires foe EVERY heartbeat. If the pacemaker did not fire, his heart would not beat.

Thanks for your input.

Gene