If pathogenic microflora enters the bone marrow of a person, then there is a high risk that he will suffer from an ailment called acute hematogenous osteomyelitis. This is an inflammation of a purulent type, as it develops, more and more large areas of bone material and soft tissues are affected. As a rule, this pathology is most often diagnosed in adolescents or, conversely, in older people. It must be understood that such a pathology is extremely dangerous for its acute form and possible complications. In some cases, patients cannot even be saved. Therefore, you need to know what acute hematogenous osteomyelitis is. This inflammation is treatable, but only if the patient seeks help in a timely manner. But even in such situations, there is a risk that some parts of the body are already severely affected.
General information
Acute hematogenous osteomyelitis develops against the background of vital activity of pyogenic microflora. However, the main causative agent of the disease is staphylococcus aureus. Sometimes these microorganismsenterobacteria are added, which further complicates diagnosis and treatment.
Infection occurs by the penetration of dangerous microbes through the bloodstream. This means that you can become infected with the disease even through a small wound on the skin or mucous membrane. Acute hematogenous osteomyelitis is more susceptible to those people who suffer from frequent inflammation of the nasopharynx, pustular formations on the skin. Sometimes there are situations when the infection is already in the body, but simply remains in a latent state. This disease also occurs in infants. As a rule, in this case, acute hematogenous osteomyelitis in newborns appears due to umbilical wounds. Through them, the virus easily enters the body of the baby. At such a young age, this is a great danger.
If we talk about the causes of acute hematogenous osteomyelitis, then infection is often provoked by the transition of a purulent process to bone material and adjacent soft tissues or even internal organs. For example, an odontogenic form of the disease is distinguished, which can occur against the background of advanced caries. There is osteomyelitis of the rib, phalanx and many other varieties.
Why pathology is more often diagnosed in children
It's all about the age anatomical structure and the blood supply system of the bone material. In children, the network of blood vessels is more developed. The blood supply system itself is constantly working offline. At the same time, many small vessels continue to develop and grow.
The blood supply system is completely formed by the age of two. Until this momentthere is a greater risk that the metaepiphyseal zone will be affected. However, parents of older children and adolescents should not relax. After two years, there is a chance (not so big, but still there) that the diaphragm will suffer.
Causes of pathology
Acute hematogenous osteomyelitis does not appear just like that. Most often, doctors diagnose infection against the background of:
- Staphylococcus aureus;
- streptococci;
- Haemophilus influenzae;
- Staphylococcus epidermidis;
- Pseudomonas aeruginosa;
- Koch sticks.
Third-party problems can also lead to this ailment. For example, treatment of acute hematogenous osteomyelitis may be required after a bone fracture, joint transplantation, against the background of kidney failure, diseases that weaken the immune system (for example, AIDS, diabetes mellitus, etc.), beriberi, drug addiction, frequent changes in temperature, and many other.
If the bone is affected by pathogenic microorganisms, then leukocytes begin to move more actively towards the affected area. This leads to a large release of lytic enzymes, which provoke the process of bone tissue decomposition. Pus with great speed begins to spread through the vessels of the circulatory system. Necrotic bone tissue begins to be torn away. All this becomes more than a favorable environment for the active reproduction of pathogens. There is an acute inflammation of a purulent type, which can easily turn into a chronic stage.
Varieties of disease
Acute hematogenous osteomyelitis of the bones is caused by the entry of harmful microorganisms into the body. The most commonly affected are:
- tubular bones that are in the hands and feet of a person;
- bone material of the upper jaw;
- vertebral column and ribs.
There are several types of pathology: postoperative, post-traumatic and gunshot. As a rule, pathology in this case develops against the background of infection of the bones. For example, if bones are crushed during an operation or due to an injury, then it is in this zone that the inflammatory process begins. Gradually, the lesion reaches the bone marrow, purulent cavity formations and fistulas appear.
It will also be useful to learn more about the classification of forms of the disease.
Toxic
This form is often called adynamic. In this case, we are talking about a rather rapid course of acute hematogenous osteomyelitis. In medical practice, there were even situations when patients experienced endotoxic shock. A person's body temperature rises strongly (it can reach up to 41 ° C), he loses consciousness, begins to rave. Also, this condition may be accompanied by vomiting and rather severe convulsions.
If we talk about the signs of the toxic form of the disease, then sometimes there is no clear clinical picture. For example, a patient may have shortness of breath, but he does not attach much importance to it. Doctors recommend not to delay and visit a specialist, as it is necessary to examine the cardiovascularsystem. Often, after diagnostic measures, problems in the work of the peripheral circulation are revealed. Patients may also complain of low blood pressure. If left untreated, there is a risk of myocarditis.
Speaking about the clinical picture of the onset of acute hematogenous osteomyelitis, it is worth paying attention to external manifestations. Often, the toxic form of pathology manifests itself in the form of small hemorrhages on the skin. The tongue becomes dry, an unpleasant brown coating appears on it. Patients complain of frequent bloating and pain in the upper sections. It can also be caused by an enlarged liver.
If a patient begins to show signs of severe toxicosis, then it becomes very difficult to identify the focus of the disease. Therefore, doctors often have to wait until the patient's condition stabilizes in order to accurately find the location of the concentration of harmful microorganisms.
Considering the classification of acute hematogenous osteomyelitis, it is worth paying attention to the fact that it is the toxic form of the disease that is considered the most dangerous, since it sometimes leads to death. Even if treatment with powerful antibiotics is started in a timely manner or an operation is performed, there is always a risk that it will not be possible to completely get rid of the infection.
Septicopyemic
Clinical classification of acute hematogenous osteomyelitis includes another type of disease. If we are talking about the septicopyemic form of pathology, then in this case the symptoms will be clearer. But, on the other hand, in this casedoctors are able to notice bone lesions much later.
This form of acute illness begins to manifest itself with a high body temperature. Gradually, the signs of intoxication become more pronounced. Vital organs stop working properly. This leads to the fact that a person suffers from confusion, delirium, often patients fall into a state of euphoria.
Special attention should be paid to the fact that from the very first days the affected limbs begin to hurt very much. In order to prevent the spread of purulent processes to other bones, lungs, heart, etc., therapy should be started immediately.
Local
The clinical picture of the onset of acute hematogenous osteomyelitis of this form differs from the previous ones. The most obvious signs of pathology are purulent formations. This explains the fact that this acute form manifests itself in the form of severe pain in the area of the affected limb.
The local form is quite easy to diagnose, since even a child will accurately show the doctor where exactly he is experiencing pain. If we talk about the recommendations of doctors regarding diagnosis at home, then the clinical picture can be identified independently if you ask the child to bend the limb and try to hold it in one position for a while. If this causes a strong reaction and severe pain, then you should immediately visit a doctor.
It is also worth paying attention to the indicators of body temperature. As a rule, it rises to 38-39 ° C. AtIn this case, the child behaves sluggishly, his appetite disappears, signs of intoxication begin to appear.
The main danger of the disease in any form is the symptomatology of acute hematogenous osteomyelitis. Clinical recommendations and a clearer picture of the course of the pathology can often be seen only after a few weeks. The disease develops gradually, and often patients seek help only when they already suffer from obvious signs of intoxication. Therefore, experts recommend not to ignore any changes in your he alth. If we are talking about such a dangerous pathology, then the consequences can be dire.
Complications of acute hematogenous osteomyelitis
Since the development of this pathology is accompanied by a fairly rapid spread of pus and inflammation, you need to understand that the disease in its advanced form can lead to certain consequences. Among them:
- Sympathetic articular hydrops. It can be attributed to one of the varieties of collateral inflammation.
- Suppuration of the joints. If the purulent node manages to break through the bone epiphysis, then the lesion will already pass to the articular bag. For example, if osteomyelitis has affected the femoral neck, then the femoral joint will suffer. This complication is considered very serious. This can lead to a complete disruption of the functioning of the affected joint. The only way to treat this complication is to inject strong antibiotics directly into the affected area.
- The defeat of the epiphysis of the bone. Most often, this complication occurs inlittle children. In this case, we are talking about a violation of bone growth, which, of course, will greatly affect the he alth of the baby and his quality of life.
- Extensive necrosis. This happens against the background of the fact that new bone material ceases to form.
- Pathological fractures. Often this complication does not appear immediately. It can take up to 3 months after getting rid of the disease. However, if part of the bone is dead, then the patient will have to face new problems.
Diagnostic measures
When you find the first likely signs of illness, you should undergo an examination. Diagnosis of acute hematogenous osteomyelitis should be made as early as possible. How soon the doctor will identify the pathology depends on how soon he will prescribe treatment. As a rule, not only laboratory, but also instrumental methods are used for diagnostic measures.
First of all, the doctor collects an anamnesis. It is necessary to tell when the first noticeable signs of the disease appeared, how intense they were, what preceded the first manifestations of the pathology, and so on. It's better not to miss anything. After talking with the doctor, the patient is sent for electroradiography. Thanks to this method of examination, it is possible to obtain a clear image of the human body and identify the focus of inflammation. Next is thermography. The patient's body is examined using infrared radiation.
At the next stage of diagnosis, a bone puncture is performed. To do this, from the focus of inflammation with the help of a thin long needle is takena small amount of tissue that is closely examined. Radionuclide diagnostics can also be carried out. It allows you to study the structure of the affected bone. The procedure is carried out by introducing a special contrast agent, which allows you to get a fairly clear clinical picture.
If necessary, can be additionally performed:
- CT. Thanks to sensitive computer processing, the doctor can determine the clear boundaries of the inflamed focus.
- MRI. Another way of computer diagnostics.
- Ultrasound.
It is also recommended to donate blood and urine for analysis. This will help determine hemodynamics. Based on this, it will be clear whether inflammatory processes are taking place in the patient's body.
Basic treatments for acute hematogenous osteomyelitis
It should be noted right away that this pathology is very difficult to treat with therapeutic measures. First of all, you will have to undergo a long course of treatment with strong antibiotics. As a rule, such treatment of acute hematogenous osteomyelitis can last up to 5 months. However, even if the clinical symptoms have disappeared and the patient feels much better, there is always a risk that the disease will return. Therefore, it is important to undergo constant examinations in order to prevent a relapse in time.
Many believe that the main treatment for acute hematogenous osteomyelitis is surgery. In fact, most experienced professionals prefer complex therapy. This means that in addition totaking antibiotics, sanitation of inflammatory foci is carried out, a course of taking anti-inflammatory drugs and much more.
You need to understand that antibacterial agents have a lot of side effects. However, without their participation it is impossible to talk about a full recovery. In the most difficult cases, even such drug therapy becomes powerless. In such situations, it remains only to perform an operation, clean the wounds and remove all dead tissue. After that, a drainage system must be installed.
If intensive treatment gives good results, then it is followed by physiotherapy, as well as exercise therapy. Such procedures allow you to strengthen the entire body and restore the functions of the affected parts. As a rule, specialists prefer infrared laser therapy, UHF, electrophoresis and other procedures.
However, this does not mean that the patient should relax. A he althy lifestyle plays an equally important role in the recovery process. Therefore, you need to give preference to a he althy and proper diet. Additionally, the doctor may prescribe vitamin complexes and other supplements that can strengthen the body.
Recommendations for recovery and prevention
To forget about this unpleasant pathology forever and not accidentally provoke a relapse, you should heed the advice of doctors who offer to undergo an additional course of treatment in a sanatorium or resort under the supervision of specialists.
You can talk about full recovery after an illness, but you need toKeep in mind that this depends on many factors. For example, the age of the patient, as well as the stage of the pathology, affects a lot. The faster the disease was identified, the greater the chance that the patient will be able to overcome it.
It should be understood that for 2-3 years after the patient has overcome the disease, he must be very careful. However, in this case, no one is ready to exclude the possibility of relapse. Therefore, it is better to prevent the disease before it appears. To do this, you need to sleep and rest. You can not succumb to stress or live in adverse environmental conditions. It is worth strengthening your immunity and giving preference to a he althy lifestyle.
It must be remembered that even the simplest caries can provoke pathology. Therefore, it is necessary to treat your teeth in a timely manner. If the patient has been diagnosed with sinusitis, then you should be very careful.
Osteomyelitis is a very insidious disease of an infectious type. It is not easy to treat, so it is best to undergo examinations in a polyclinic in a timely manner. Each person must independently monitor any changes in his condition. When the first alarming symptoms appear, do not postpone the solution of the problem. Otherwise, you can miss a dangerous disease and get terrible complications. Only timely adequate treatment will help overcome the pathology, and in some cases even save a person's life.
