Osteomyelitis is a severe suppurative necrotic disease of the bone marrow. It affects not only the bone marrow, but the entire bone, and then it is transmitted to nearby tissues. The causative agents of the disease are bacteria or mycobacteria that produce pus.
Bone osteomyelitis can be transmitted in different ways:
through the bloodstream (hematogenous variety),
from the focus of another inflammation,
with penetrating wounds or fracture treatment (post-traumatic type),
during dental treatment or the installation of dentures (odontogenic type).
When bacteria enter the body, their accumulation site is surrounded by leukocytes, which, in an effort to destroy the infection, produce enzymes that destroy bone. The bone, bone marrow, soft takens and tendons surrounding them die off, and then become covered with new bone tissue, forming a place for a permanent infection.
By examining the inflamed area, you can determine the type of osteomyelitis. It can be acute or chronic. In turn, acute bone osteomyelitis is also divided into varieties caused by various causes and occurring in different ways.
Osteomyelitis in newborns occurs in one third of babies. The infection affects the tubular bones, and in the most severe cases, multiple lesions occur. This often leads to lifelong arthritis.
Acute osteomyelitis can be septicemic, local or toxic.
Symptoms of the first type: a sharp significant increase in temperature, delirium, repeated vomiting, jaundice, loss of consciousness.
Local bone osteomyelitis develops extremely rapidly. During a day or two, the temperature rises, there is swelling of the skin, redness. Severe pain changes the position of the affected limbs, giving them a forced unnatural position. The limb loses the ability to move. However, in general, the condition of the patient is somewhat easier than with the septic-pemic form.
The toxic form proceeds lightning fast, but is quite rare. Symptoms grow like a snowball. The temperature rises sharply, acute intoxication of the body is observed. It accompanies severe vomiting, the symptoms of meningitis increase. Convulsions are becoming more frequent, which are replaced by adynamia, in which a person is not able to move. Pressure drops to a critical level, cardiac arrest may occur . Since, unlike other forms, general symptoms appear first, rather than local symptoms, making the correct diagnosis can be difficult.
Osteomyelitis of the upper jaw can occur as a result of advanced caries (odontogenic), get through the blood from a tooth or other affected organ (hematogenous), develop due to any trauma (post-traumatic).
Odontogenic osteomyelitis often occurs in the lower jaw, and the upper is affected only in a third of cases. The causative agents of this species are streptococci, staphylococci, anaerobic bacteria.
The source of infection with hematogenous osteomyelitis of the jaw can be tonsillitis, scarlet fever, typhoid, any other infectious or purulent diseases.
Symptoms of jaw osteomyelitis :
sharp pain in the tooth, worse when tapped,
loosening of teeth adjacent to the infected,
swelling of the oral mucosa, the appearance of abscesses,
enlarged lymph nodes in the neck,
jaundice,
temperature rise,
lethargy,
sharp fluctuation in pressure.
When diagnosed with bone osteomyelitis, a step-by-step treatment is prescribed:
- removal of affected tissue. It is carried out by an operational way;
- filling the bone with material taken from donors and purified of all antigenic substances;
- complex treatment with drugs, including antibiotics.
Osteomyelitis in chronic form leads to the formation of purulent fistulas, sometimes to a change in the length of the limb. The period of remission can last for many years.