If your kids are like most, they're probably pretty active and not always as careful as they should be. Minor scrapes and bruises that develop on their arms and legs will usually heal on their own — but deeper wounds that are left untreated can become infected, and lead to a bone infection. In medical terms, that's called osteomyelitis.
Osteomyelitis is most commonly caused by the bacterium Staphylococcus aureus, but other bacteria can cause it, too. Germs usually enter the body's tissues through an open wound (often a broken bone that breaks the skin), but can also travel to a bone through the bloodstream from another infected area in the body (this is called hematogenous osteomyelitis).
A bone also can become infected when the blood supply to that area is disrupted, such as in older people with atherosclerosis (a narrowing of the blood vessels) or in those with diabetes. Atherosclerosis or diabetes-related bone infections usually occur in the toes or other bones in the feet. Osteomyelitis from other causes usually affects the long bones of the arms and legs.
Kids with osteomyelitis often feel severe pain in the infected bone, and might have fever and chills, feel tired or nauseated, or have a general feeling of not being well. The skin above the infected bone may be sore, red, and swollen.
It's often difficult to diagnose osteomyelitis in infants and young children because they don't always show pain or feel specific symptoms in the area of the infection. Additionally, older people with atherosclerosis or diabetes sometimes lose the ability to feel pain (called neuropathy), so their symptoms also might not be evident. In teens, who tend to develop osteomyelitis after an accident or injury, the injured area may begin to hurt again after initially seeming to get better.
If your child has a fever and bone pain, visit the doctor right away. Waiting is not recommended because osteomyelitis can get worse within hours or days and become much more difficult to treat.
The doctor will perform a physical exam and ask questions about recent injuries to the area that's painful. Blood tests might be done to see whether the white blood cell count is elevated (a sign of infection) and to look for signs of possible inflammation or infection in the body. An X-ray may be ordered; however, X-rays usually don't show signs of infection in someone who has had osteomyelitis for a little while.
If osteomyelitis is suspected, the doctor might suggest a bone scan, which provides a more detailed look at the bone. The doctor might also recommend an MRI (magnetic resonance imaging), which produces much more detailed images than X-rays. MRIs not only can diagnose osteomyelitis, but can help establish how long the bone has been infected.
Treatment of osteomyelitis depends on the severity of the infection and whether it is acute (recent) or chronic (has been present for a longer period of time). The doctor may perform a needle aspiration, removing a sample from the bone to help identify the bacteria responsible for the infection, which will help determine the correct antibiotic to treat that particular infection.
A child who's diagnosed with severe osteomyelitis may be admitted to the hospital for a short stay so that intravenous (IV) antibiotics can be given to fight the infection. Once the condition improves, kids can go home but may need to continue IV or oral antibiotics for several more weeks.
In cases where a cavity or hole developed in the bone and pus (a large collection of bacteria and white blood cells) filled this area, a doctor will perform debridement. This is a procedure to clean the wound, remove dead tissue, and drain pus out of the bone so that it can heal properly.
The easiest way to prevent osteomyelitis is to practice good hygiene. All cuts and wounds — especially deep wounds — should be cleaned thoroughly. Wash a wound with soap and water, holding it under running water for at least 5 minutes to flush it out.
To keep the wound clean afterward, cover it with sterile gauze or a clean cloth. You can apply an over-the-counter antibiotic cream, too, but the most important thing is to keep the area clean. Wounds should begin healing within 24 hours and completely heal within a week. A wound that's taking longer to heal or is causing your child extreme pain should be examined by a doctor.
Reviewed by: Catherine L. Lamprecht, MD
Date reviewed: October 2013
|National Safety Council The National Safety Council offers information on first aid, CPR, environmental health, and safety.|
|American Medical Association (AMA) The AMA has made a commitment to medicine by making doctors more accessible to their patients. Contact the AMA at: American Medical Association|
515 N. State St.
Chicago, IL 60610
|Centers for Disease Control and Prevention (CDC) The mission of the CDC is to promote health and quality of life by preventing and controlling disease, injury, and disability. Call: (800) CDC-INFO|
|Checking Out Cuts, Scratches, and Abrasions If you're wearing a bandage right now, chances are you have a cut, scratch, or abrasion. Find out more about them in this article for kids.|
|Cellulitis Cellulitis is an infection of the skin and underlying tissues that can affect any area of the body. It begins in an area of broken skin, like a cut or scratch.|
|Cellulitis Cellulitis is a skin infection that involves areas of tissue just below the skin's surface. It can affect any part of the body, but it's most common on exposed areas, such as the face, arms, or lower legs.|
|Cellulitis Cellulitis is a serious infection that can be mistaken for a bruise, scrape, or insect bite. Find out more in this article for kids.|
|Osteomyelitis Sometimes a bad cut that gets infected can lead to even worse things, like a bone infection called osteomyelitis. The easiest way to protect yourself is to practice good hygiene.|
|Why Do I Need to Wash My Hands? Washing your hands is the best way to stop germs from spreading. Learn all about the best way to wash your hands in this article for kids.|
|Why Is Hand Washing So Important? Did you know that proper hand washing is the best way to keep from getting sick? Here's how to teach this all-important habit to your kids.|
|Wound Healing and Care How well a wound heals depends on where it is on the body and what caused it – as well as how well someone cares for the wound at home. Find out what to do in this article for teens.|
|Cuts, Scratches, and Scrapes Most small cuts, scrapes, or abrasions heal on their own. Here are tips for teens on how to treat cuts at home - and when to get medical help.|
|Dealing With Broken Bones A broken bone requires emergency medical care. Find out what to do in this printable instruction sheet.|
|Dealing With Cuts and Wounds Most cuts can be safely treated at home, but deep cuts and certain other injuries require medical treatment. Find out what to do by reading this printable instruction sheet.|
|Bones, Muscles, and Joints Without bones, muscles, and joints, we couldn't stand, walk, run, or even sit. The musculoskeletal system supports our bodies, protects our organs from injury, and enables movement.|
|First Aid & Safety Center Boo-boos, bug bites, and broken bones - oh my! Here's your one-stop shop for everything you need to know about how to keep kids safe.|
|Broken Bones Although many kids will have one at some point, a broken bone can be scary for them and parents alike. To help make things a little easier if a spill results in a fracture, here's the lowdown on what to expect.|
|Bones, Muscles, and Joints Our bones, muscles, and joints form our musculoskeletal system and enable us to do everyday physical activities.|
|The Facts About Broken Bones What happens when you break a bone?|
|Hand Washing Did you know that the most important thing you can do to keep from getting sick is to wash your hands? If you don't wash your hands frequently, you can pick up germs from other sources and then infect yourself.|
|Dealing With Cuts Find out how to handle minor cuts at home - and when to seek professional treatment.|
|Staph Infections When skin is punctured or broken for any reason, staph bacteria can enter the wound and cause an infection. But good hygiene can prevent many staph infections. Learn more.|
|Staph Infections Staph bacteria can live harmlessly on many skin surfaces. But the bacteria can get into wounds and cause an infection. Get the details in this article for teens.|
|MRSA MRSA is a type of bacteria that the usual antibiotics can't tackle anymore. Simple precautions can help protect your kids from becoming infected.|
|MRSA MRSA is a type of bacteria that the usual antibiotics can't tackle anymore. The good news is that there are some simple ways to protect yourself from being infected. Find out how.|
What to expect when coming to Akron Children's
For healthcare providers and nurses
Residency & Fellowships, Medical Students, Nursing and Allied Health
For prospective employees and career-seekers
Our online community that provides inspirational stories and helpful information.