If pathogenic microflora gets into the bone marrow of a person, then there is a big risk that he will suffer from an ailment called acute hematogenous osteomyelitis. This is an inflammation of a purulent type, as it develops, more and more large areas of bone material and soft tissues are affected. As a rule, this pathology is most often diagnosed in adolescents or, conversely, in older people. It must be understood that such a pathology is extremely dangerous for its acute form and possible complications. In some cases, patients cannot even be rescued. Therefore, you need to know what acute hematogenous osteomyelitis is. This inflammation is treatable, but only if the patient promptly seeks help. But even in such situations, there is a risk that some parts of the body are already severely affected.
general information
Acute hematogenous osteomyelitis develops against the background of vital activity of pyogenic microflora. However, the main causative agent of the disease is staphylococcus. Sometimes enterobacteria are added to these microorganisms, which further complicates the diagnosis and treatment.
Infection occurs by the penetration of dangerous microbes through the bloodstream. This means that you can become infected even through a small wound on the skin or mucous membrane. Acute hematogenous osteomyelitis is more prone to those people who suffer from frequent inflammation of the nasopharynx, pustular formations on the skin. Sometimes there are situations when the infection is already in the body, but simply remains in a latent state. This disease occurs in infants. As a rule, in this case, acute hematogenous osteomyelitis in newborns appears due to umbilical wounds. Through them, the virus easily enters the baby's body. At such a young age, this poses a great danger.
If we talk about the causes of acute hematogenous osteomyelitis, then often the infection is provoked by the transition of the purulent process to bone material and adjacent soft tissues or even internal organs. For example, a odontogenic form of the disease is distinguished, which can occur against the background of advanced caries. Osteomyelitis of the ribs, phalanges, and many other varieties are found.
Why is pathology more often diagnosed in children
It's all about the age-related anatomical structure and the blood supply system of bone material. In children, the network of blood vessels is more developed. The blood supply system itself is constantly working offline. However, many small vessels continue to develop and grow.
A complete blood supply system is formed by two years. Up to this point, there is a greater risk that a metaepiphyseal lesion will occur. However, parents of older children and adolescents should not relax. After two years, there is a possibility (not so great, but it is still there) that the diaphragm will suffer.
Causes of the appearance of pathology
Acute hematogenous osteomyelitis does not appear just like that. Most often, doctors diagnose infection against the background of:
- Staphylococcus aureus;
- streptococci;
- hemophilic bacillus;
- epidermal staphylococcus;
- Pseudomonas aeruginosa;
- Koch sticks.
Third-party problems can lead to this ailment. For example, treatment of acute hematogenous osteomyelitis may be required after a bone fracture, joint transplantation, against the background of renal failure, diseases that weaken the immune system (for example, AIDS, diabetes mellitus, etc.), vitamin deficiency disorders, drug addiction, frequent changes in temperature regimes and much of another.
If the bone is affected by pathogenic microorganisms, then the white blood cells begin to move more actively towards the affected area. This leads to a large release of lytic enzymes that provoke the process of decomposition of bone tissue. Pus begins to spread with great speed through the vessels of the circulatory system. Necrotic bone tissue begins to be rejected. All this becomes more than a favorable environment for the active reproduction of pathogens. There is an acute inflammation of a purulent type, which can easily go into the chronic stage.
Varieties of ailment
Acute hematogenous bone osteomyelitis is caused by the entry of harmful microorganisms into the body. In this case, most often affected:
- tubular bones that are in the arms and legs of a person;
- bone material of the upper jaw;
- spinal column and ribs.
There are several types of pathology: postoperative, post-traumatic and gunshot. As a rule, the pathology in this case develops against the background of infection of the bones. For example, if during a surgery or due to a wound in a person, the bones are broken, then it is in this zone that the inflammatory process begins. Gradually, the lesion reaches the bone marrow, purulent cavity formations and fistulas appear.
It will also be useful to learn more about the classification of the forms of the disease.
Toxic
This form is often called adynamic. In this case, we are talking about a rather rapid course of acute hematogenous osteomyelitis. In medical practice, there have even been situations when patients experienced endotoxic shock. A person’s body temperature rises strongly (can reach 41 ° C), he loses consciousness, begins to rave. Also, this condition can be accompanied by vomiting and quite severe convulsions.
If we talk about the signs of a toxic form of the disease, then sometimes a clear clinical picture is not observed. For example, a patient may have shortness of breath, but he does not attach strong importance to it. Doctors recommend not delaying and visiting a specialist, since you need to examine the cardiovascular system. Often, after diagnostic measures, problems in the work of peripheral blood circulation are identified. Also, patients may complain of low blood pressure. If you do not do treatment, then there is a risk of myocarditis.
Speaking about the clinical picture of the onset of acute hematogenous osteomyelitis, it is worth paying attention to external manifestations. Often, a toxic form of pathology manifests itself in the form of small hemorrhages on the skin. The tongue becomes dry, an unpleasant brown coating appears on it. Patients complain of frequent bloating and pain in the upper sections. This can be caused by enlarged liver.
If the patient begins to show signs of severe toxicosis, then it becomes very difficult to identify the focus of the disease. Therefore, doctors often have to wait until the patient's condition stabilizes in order to accurately find the location of the concentration of harmful microorganisms.
When considering the classification of acute hematogenous osteomyelitis, it is worth paying attention to the fact that it is the toxic form of the disease that is considered the most dangerous, since it sometimes leads to death. Even if you start treatment with powerful antibiotics in a timely manner or undergo surgery, there is always a risk that you can’t completely get rid of the infection.
Septicopyemic
The clinical classification of acute hematogenous osteomyelitis includes another type of ailment. If we are talking about a septicopyemic form of pathology, then in this case the symptoms will be more clear. But, on the other hand, in this case, doctors manage to notice lesions of bone material much later.
This form of acute illness begins to appear with a high body temperature. Gradually, signs of intoxication are becoming more pronounced. Vital organs stop working properly. This leads to the fact that a person suffers from confused consciousness, delirium, often patients fall into a state of euphoria.
Particular attention should be paid to the fact that from the very first days, the affected limbs begin to get very sick. In order to prevent the spread of purulent processes to other bones, lungs, heart, etc., therapy should be started immediately.
Local
The clinical picture of the onset of acute hematogenous osteomyelitis of this form differs from the previous ones. The most obvious signs of pathology are purulent formations. This explains the fact that this acute form manifests itself in the form of severe pain in the affected limb.
The local form is quite easy to diagnose, since even a child will accurately show the doctor where exactly he is experiencing pain. If we talk about the recommendations of doctors regarding diagnosis at home, then the clinical picture can be identified independently, if you ask the child to bend the limb and try to keep it in one position for some time. If this causes a strong reaction and acute pain, then you should immediately visit a doctor.
It is also worth paying attention to indicators of body temperature. As a rule, it rises to 38-39 ° C. In this case, the child behaves sluggishly, his appetite disappears, signs of intoxication begin to appear.
The main danger of the disease in any form is the symptomatology of acute hematogenous osteomyelitis. Clinical recommendations and a clearer picture of the pathology can often be seen only after a few weeks. The disease develops gradually, and often patients seek help only when they already suffer from obvious signs of intoxication. Therefore, experts recommend that you do not ignore any changes in the state of your health. If we are talking about such a dangerous pathology, then the consequences can be disastrous.
Complications of acute hematogenous osteomyelitis
Since with the development of this pathology there is a rather rapid spread of pus and inflammation, you need to understand that an ailment in a neglected form can lead to certain consequences. Among them:
- Sympathetic articular hydrops. It can be attributed to one of the varieties of collateral inflammation.
- Suppuration of the joints. If the purulent node manages to break through the bone pineal gland, then the lesion will go to the joint bag. For example, if osteomyelitis has affected the neck of the thigh, the hip joint will suffer. This complication is considered very serious. This can lead to a complete disruption of the functioning of the affected joint. The only way to treat this complication is to administer potent antibiotics directly to the affected area.
- Lesion of the pineal gland. Most often, this complication occurs in young children. In this case, it is a violation of bone growth, which, of course, will greatly affect the baby’s health and quality of life.
- Extensive necrosis. This happens against the background of the fact that new bone material ceases to form.
- Pathological fractures. Often this complication does not appear immediately. It can take up to 3 months after getting rid of the disease. However, if part of the bone is dead, then the patient will have to face new problems.
Diagnostic measures
If you find the first likely signs of an ailment, you should undergo an examination. Diagnosis of acute hematogenous osteomyelitis should be made as early as possible. How quickly the doctor reveals the pathology depends on how soon he will prescribe the treatment. As a rule, for diagnostic measures, not only laboratory, but also instrumental methods are used.
First of all, the doctor collects an anamnesis. It is necessary to tell when the first noticeable signs of the disease appeared, how intense they are, which preceded the first manifestations of pathology and so on. Better not to miss anything. After a conversation with the doctor, the patient goes for an X-ray. Thanks to this method of examination, it is possible to obtain a clear image of the human body and identify the focus of inflammation. Next is carried out thermography. The patient's body is examined using infrared radiation.
At the next stage of diagnosis, bone puncture is performed. To do this, a small amount of tissue is taken from the focus of inflammation using a thin long needle, which is carefully examined. Radionuclide diagnostics can also be performed. It allows you to study the structure of the affected bone. The procedure is carried out by introducing a special contrast agent, which allows you to get a fairly clear clinical picture.
If necessary, can be additionally performed:
- CT Thanks to sensitive computer processing, the doctor can determine the clear boundaries of the inflamed area.
- MRI Another way of computer diagnostics.
- Ultrasound
It is also recommended to donate blood and urine for analysis. This will help determine hemodynamics. Based on this, it will be clear whether inflammatory processes occur in the patient's body.
The main methods of treatment of acute hematogenous osteomyelitis
It is immediately worth noting that this pathology is very difficult to respond to therapeutic measures. First of all, you will have to undergo a long course of treatment with strong antibiotics. As a rule, such treatment of acute hematogenous osteomyelitis can last up to 5 months. However, even if the clinical symptoms have disappeared and the patient is feeling much better, there is always a risk that the disease will return. Therefore, it is important to undergo regular examinations in order to prevent relapse in time.
Many believe that the main treatment for acute hematogenous osteomyelitis is surgery. In fact, most experienced professionals prefer complex therapy. This means that in addition to taking antibiotics, sanitation of inflammatory foci is carried out, a course of taking anti-inflammatory drugs, and much more.
You need to understand that antibacterial agents have a lot of side effects. However, without their participation it is impossible to talk about full recovery. In the most difficult cases, even such drug therapy becomes powerless. In such situations, it remains only to carry out the operation, clean the wounds and remove all dead tissue. After that, a drainage system is installed.
If intensive treatment gives good results, then physiotherapy, as well as exercise therapy, should follow. Such procedures can strengthen the whole body and restore the function of the affected parts. As a rule, specialists prefer infrared laser therapy, UHF, electrophoresis and other procedures.
However, this does not mean that the patient should relax. A healthy lifestyle plays an equally important role in the recovery process. Therefore, you need to give preference to a healthy and proper diet. Additionally, the doctor may prescribe vitamin complexes and other supplements that can strengthen the body.
Recovery and Prevention Recommendations
In order to forever forget about this unpleasant pathology and not accidentally provoke a relapse, it is worth listening to the advice of doctors who offer to undergo an additional course of treatment in a sanatorium or resort under the supervision of specialists.
You can talk about a full recovery after an ailment, but you need to consider that this depends on numerous factors. For example, the age of the patient, as well as the stage of the pathology, affects a lot. The faster the ailment was identified, the greater the chance that the patient will be able to overcome it.
It should be understood that for 2-3 years after the patient has overcome the disease, he must be very careful. However, in this case, no one is ready to rule out the possibility of relapse. Therefore, it is better to prevent the ailment before it appears. To do this, you need to get enough sleep and rest. You can not give in to stress or live in adverse environmental conditions. It is worth strengthening your immunity and giving preference to a healthy lifestyle.
It must be remembered that even the simplest caries can provoke pathology. Therefore, you need to do dental treatment in a timely manner. If the patient has been diagnosed with sinusitis, then you should be very careful.
Osteomyelitis is a very insidious disease of an infectious type. It is not easy to treat, so it is best to undergo examinations in a clinic in a timely manner. Each person should independently monitor any changes in his condition. When the first alarming symptoms appear, do not postpone the solution to the problem. Otherwise, you can miss a dangerous ailment and get the worst complications. Only timely, adequate treatment will help overcome pathology, and in some cases even save a person’s life.