Abscesses of the bone (bone abscess) are also called osteomyelitis. A distinction is made here between an endogenous and an exogenous form. The endogenous form is caused by bacteria (especially staphylococci, Pseudomonas and Proteus) from the blood side, i.e. by bacteria in the blood.
The exogenous form usually occurs after fractures or injuries of soft tissue. Through this trauma opening, bacteria can then migrate into the bone and lead to a bone abscess. The endogenous form is mainly found in adolescents (up to 16 years of age), while adults are less likely to contract the endogenous form.
Symptoms of bone abscess
Patients with an acute bone abscess usually complain of chills, high fever and have elevated leukocyte values and a so-called left shift (increased young and immature blood cells). Furthermore, there is a local pressure pain at the site of the abscess and an accompanying pasty swelling of the surrounding tissue. In chronic abscesses there is a risk of fistula formation. In this case the patient’s complaints are usually not as acute as in the acute form.
Diagnosis
First, the blood count gives a first indication of the severity of the disease. During the rise in fever, blood cultures should be taken in order to possibly obtain a corresponding germ proof. An x-ray of the corresponding bone can give an indication of a bone abscess by a slight brightening (usually at the beginning of a disease).
The further a bone abscess progresses, the looser the bone structure at the corresponding site appears. Furthermore, an ultrasound, an MRI or a skeletal scintigraphy can be performed. During an operation, a smear can also be taken in order to obtain the corresponding bacteria.
The therapy of a bone abscess
Complications of a bone abscess
First of all, there is a risk that an acute abscess can develop into a chronic form that recurs again and again and has to be operated on several times. After surgical removal of the abscess, inflammation, wound healing disorders and post-operative infections may occur, making repeat surgery necessary. In extreme individual cases, it may become necessary to amputate the affected extremity to protect the body from life-threatening blood poisoning.
