• Infection of the bone and the bone marrow.
• Caused by direct invasion from an open wound or a systemic infection.
• Caused by lowered body resistance and decreased blood flow to the bones
• Osteomyelitis is an infection of the bone, bone marrow, and surrounding soft tissue.
• The most common causative organism is Staphylococcus aureus.
• Inflammatory response occurs initially, with increased vascularization and edema.

ETIOLOGIES

• Escherichia coli
• Neisseria gonorrhea
• Salmonella typhi
• Staphylococcus aureus (most common)

CLINICAL & DIAGNOSTIC FINDINGS

• Fever (systemic and local)
• Pain and lack of desire to use affected limb
• Culture of drainage revealing infectious microorganism
• Elevated WBC and neutrophils (WBC: 5000-10000/mm³; Neutrophils: 50-70 %)
• Weakness, headache, nausea and vomiting
• Redness, edema and inflammation
• History of trauma

DIAGNOSTIC STUDIES

• CBC- WBC may be elevated (indicates presence of active infection).
• ESR (erythrocyte sedimentation rate) – may be elevated (indicates inflammatory process).
• Bone Scan (indicates infected bone).

• Bone lesion biopsy or culture (may reveal the causative organism).

NURSING INTERVENTIONS

1. Assess site of inflammation.
2. Assess drainage from irrigating tube.
3. Assist in positioning to comfort.
4. Maintain bed rest.
5. Assist in obtaining blood specimen for culture.
6. Administer antibiotics and pain medications.
7. Offer fluids and monitor fluid status.
8. Provide divertional activities.

TREATMENT

1. Intensive intravenous (IV) antibiotics; oral antibiotic therapy for 6 to 8 weeks.
2. Immobilization of affected area.
3. Surgical debridement may be necessary.
4. Hyperbaric oxygen therapy to stimulate circulation and healing.

TEACHINGS

1. Teach self-care.
2. Wound care.
3. Self-administration of antibiotics analgesics.
4. Use of ambulatory aids.
5. Complete continuity of care.