Osteomyelitis is a disease caused by an infection. It appears in the form of inflammation. The shin, hips, humerus, vertebrae, and jaw joints are most often affected. Osteomyelitis is a purulent-necrotic process that develops in the bone marrow and surrounding soft tissues. Usually the whole disease occurs in boys (2 times more often than girls) due to high mobility, fights, injuries, falls.
Why is childhood osteomyelitis an extremely dangerous disease?
Osteomyelitis in children (a photo of the external manifestations of the disease can be seen in this article) is a dangerous disease. The disease affects the bone marrow. The infection centers directly in the bones and almost does not appear externally. Therefore, it is rather difficult to diagnose the disease in children at an early stage, since they cannot accurately describe the symptoms and sensations. If acute osteomyelitis in children does not begin to be treated on time, then the skeleton of the child may deform. This disease can cause disability and serious consequences.
Forms of Osteomyelitis
Osteomyelitis is divided into two forms. The first is specific. This is a secondary disease caused by bacteria after tuberculosis, syphilis or brucellosis. But in children is rare. The second form is non-specific. It occurs due to purulent cocci and microbes.
Kinds
Osteomyelitis in a child can be of several types:
- Hematogenous. It is provoked by microorganisms that enter the bone tissue through the bloodstream. There is an acute and chronic form. The second is when the inflammation lasts more than four months. The chronic form is divided into two subspecies. Primary osteomyelitis, in which there are no clear symptoms. And secondary - as a consequence of the acute hematogenous form.
- Non-hematogenous (otherwise - exogenous or post-traumatic). It occurs due to injuries, fractures, gunshot wounds, inflammation of bone tissue.
- Odontogenic. This is an inflammation of the jaw bones . The disease occurs due to dental diseases. In children, the jaw tissue is pierced by frequent blood vessels. Therefore, inflammation spreads at high speed. But tissue repair after treatment is no less rapid. This type of osteomyelitis is found mainly in children from three to twelve years old.
- Contact. This is a type of exogenous osteomyelitis. It occurs when purulent inflammation passes to the bone from the soft tissues that surround it.
Causes of Osteomyelitis
The main causes of osteomyelitis in children are purulent infections and injuries. Often the disease is caused by:
- otitis;
- furunculosis;
- pyelonephritis;
- impetigo;
- burns;
- fractures
- wounds.
In a number of frequent pathogens of the disease is Staphylococcus aureus. It is found in osteomyelitis in eighty percent of cases. In the remaining twenty percent, patients are diagnosed with various rods (Pfeiffer, intestinal), Salmonella and streptococcus. Acute odontogenic osteomyelitis begins due to teeth affected by caries. The culprit is a pathogenic bacterial flora located in the pulp and periodontium.
Osteomyelitis in children: symptoms of the disease
The main symptoms of osteomyelitis:
- chills;
- arthritis of the extremities;
- swelling and redness of the lesion;
- weakness and lethargy;
- rapid pulse;
- increasing bone pain;
- high leukocytosis, positive blood culture and leukopenia;
- initially, you may not see changes on x-rays; they appear later.
Symptoms of osteomyelitis depend on the affected area of the bone and the age of the child. Newborns are sluggish, nervous, suffer from a lack of appetite, they have a high temperature. Sometimes vomiting and diarrhea occur.
If you watch the child, you can see how the baby protects the limb (it does not touch objects and tries not to move). The affected area may turn red, sometimes swelling appears. After a few days, they increase. If treatment is not started on time, then reproduction of purulent metastases will begin.
Older children experience the same symptoms, but they are more pronounced. Inflammation develops longer, and redness and swelling can be seen only a week after the onset of the disease.
With odontogenic osteomyelitis, pus follows from the dental canals and gums. The teeth that are next to the patient are too mobile. It starts:
- swelling of the face;
- the skin and mucous membranes turn pale;
- temperature rises;
- chills and general weakness occurs;
- babies may experience cramps;
- vomiting
- digestive upset.
This is due to severe intoxication of the body. Primary chronic osteomyelitis in a child is manifested by blurry symptoms. Small pains occur, but they do not have a clear localization.
In the secondary-chronic form of remission and exacerbation alternate (sometimes for years). In the first case, the child has no complaints, in the second, pains on palpation and fever begin. Fistulas may appear with the release of pus. With this form of the disease, the liver, heart and kidneys are affected.
Diagnostics
Diagnosis of the disease is complicated, since hematogenous osteomyelitis in children can be confused with rheumatism, suppurative arthritis or Ewing's sarcoma, the symptoms of which are similar. Sometimes, at the first sign, a malignant infection is suspected.
Treatment methods
Treatment of osteomyelitis in children is carried out using methods that affect the microorganisms that cause the disease and directly on the affected bones:
- immunotherapy;
- under the skin, staphylococcal antifagin, toxoid, vaccine and bacteriophage are introduced to lose reaction to the allergen;
- vitamin therapy;
- antibiotics are prescribed;
- eliminates pressure on the bone marrow, its roots and blood vessels;
- pathological formations that compress the nerves are removed;
- the affected area is fixed;
- surgical operations are performed with dissection of the periosteum and exfoliation of the inflamed part from the bone;
- drainage is established for the outflow of pus.
Treatment
Osteomyelitis in a child begins with antibiotic treatment. They are important in the early stages of the disease to stop the inflammatory process. Basically, drugs containing penicillin are prescribed. The course of treatment is from one to three months. At the same time, medications for thrush are prescribed, since antibiotics disrupt the microflora of the body and this disease can occur.
Surgery is sometimes necessary. The doctor reveals abscesses, rinses the channels from pus. During operations, local anesthesia is used. With odontogenic osteomyelitis, the main treatment is surgery. During it, a diseased tooth is removed, abscesses are opened, wounds are drained. Assigned:
- disintegration therapy;
- preparations containing calcium;
- antihistamines;
- antibiotics
- vitamin complexes;
- non-specific immunomodulators;
- diet (dairy and plant foods and drinking plenty of water).
Osteomyelitis in a child continues to be treated even after a hospital. Outpatient massage and physiotherapy exercises. Sanitation of the affected areas and balneotherapy are performed. The child undergoes inpatient treatment regularly twice a year. During this period, desensitizing, laser, magnet, and vitamin therapy are carried out. Immunomodulators are used. Electrophoresis and antibiotics are prescribed. An X-ray is taken every six months, then for monitoring once a year for three years. The child can be sent for spa treatment.
Prevention
To prevent the development of this disease, you need:
- observe the correct mode of wakefulness and sleep;
- adhere to a healthy lifestyle;
- do not be nervous;
- eat properly;
- strengthen immunity;
- regularly undergo a physical examination.
With all sorts of ailments, you should contact the clinic and not self-medicate. Eighty percent of all diseases can be cured at an early stage, the main thing is to make a diagnosis on time.