have sore, red, and swollen skin above the infected bone
Very young children might stop using the infected limb and protect it from being
touched. They may also be fussy or eat less.
Teens tend to get osteomyelitis after an accident or injury. The injured area may
begin to hurt again after seeming to get better.
What Causes Osteomyelitis?
Bacteria can infect bones in a few ways. For instance:
Bacteria can travel into the bone through the bloodstream from other infected
areas in the body. This is called hematogenous (heh-meh-TAH-gen-us)
osteomyelitis. It's the most common way that kids get bone infections.
A direct infection can happen when
enter a wound and travel to the bone (like after an injury or surgery).
Open fractures — breaks
in the bone with the skin also open — are the injuries that most often develop osteomyelitis.
Sometimes the bacteria can spread from a nearby infection. For example, an untreated
infection in skin or a joint can spread to the bone.
Who Gets Osteomyelitis?
Osteomyelitis is most common in young kids under age 5. But it can happen at any
age. Boys get it almost twice as often as girls do.
Is Osteomyelitis Contagious?
No, bones infections aren't contagious. But the germs
that cause osteomyelitis can sometimes pass from one person to another.
How Is Osteomyelitis Diagnosed?
If your child has a fever and bone pain, visit the doctor right away. Osteomyelitis
can get worse within hours or days and become much harder to treat.
The doctor will do a physical exam and ask questions about recent injuries to the
painful area. Blood tests can check for an increased white blood cell count (a sign
of infection) and other signs of possible inflammation or infection. An X-ray may
be ordered although X-rays don't always show signs of infection in a bone in the early
The doctor might suggest a
to get a more detailed look at the bone. The doctor might also recommend
an MRI, which gives much
more detailed images than X-rays. MRIs not only can diagnose osteomyelitis, but can
help establish how long the bone has been infected.
The doctor may do a
to get a sample from the bone. This lets the doctor find out which bacteria
caused the infection. It also can help the doctor decide which antibiotic would best
treat the infection.
How Is Osteomyelitis Treated?
Treating osteomyelitis depends on:
the age and general health of the child
how severe the infection is
whether the infection is
(has been going on for a longer time)
Treatment includes antibiotics for the infection and medicine for pain relief.
Most kids with osteomyelitis have a brief stay in the hospital to get IV (given in
a vein) antibiotics to fight the infection. They can go home when they feel better,
but might need to continue IV or oral antibiotics for several more weeks.
Sometimes surgery is needed to clean out an infected bone. If a cavity or hole
developed in the bone and is filled with pus (a collection of bacteria and white blood
cells), a doctor will do a debridement. In this procedure, the doctor
cleans the wound, removes dead tissue, and drains pus out of the bone so that it can
How Long Does Osteomyelitis Last?
Most children with osteomyelitis feel better within a few days of starting treatment.
IV antibiotics often are switched to oral form in 5 to 10 days. Kids usually get antibiotics
for at least a month, and sometimes longer depending on symptoms and blood test results.
Can Osteomyelitis Be Prevented?
One way to prevent osteomyelitis is to keep skin clean. All cuts
and wounds — especially deep wounds — should be cleaned well. 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, 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 takes longer to heal or causes extreme pain should be checked by a
And, as with many infections, parents and kids should wash
their hands well and often to stop the spread of germs. Kids also should have
kept up to date.