tryingtofeelgood

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.

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