Osteomyelitis

The specific signs and symptoms of osteomyelitis will vary depending on the type of condition:

• Acute - Acute osteomyelitis often presents with a fever, followed by pain in the affected area a few days later. Symptoms can include nausea, malaise, chills and sweating, irritability, fatigue, swollen, tender, or red skin at the site, and loss of range of motion. If the infection spreads to the muscle or skin, abscesses may form, resulting in drainage of pus through the skin.
• Chronic - Chronic osteomyelitis is often characterized by deep bone pain and symptoms similar to those of acute osteomyelitis: nausea, malaise, fevers, chills, and sweating, as well as swollen, tender, or red skin at the site. Abscesses can form if the infection has spread to the muscle or skin, causing drainage of pus through the skin. Bone destruction and formation of dead bone can occur with chronic osteomyelitis. Rarely this type of osteomyelitis can occur without symptoms.
• Hematogenous - In children, this bloodborne type of osteomyelitis typically presents with chills, pain, and signs of inflammation in the infected area. Patients may also exhibit a limited range of motion or limping. Adults may exhibit chills, dull pain, swelling, and warmth in the infected area. If the infection spreads to the muscle or skin, forming abscesses, pus may drain through the skin. With hematogenous osteomyelitis especially, a high fever may be present.
• Vertebral - Because vertebral osteomyelitis affects the spine, it can cause chronic back pain that worsens when one moves around. Other symptoms include weakness, weight loss, numbness, and tingling; abscesses can also occur, causing drainage of pus in the affected area. Patients with vertebral osteomyelitis often have pain but no other symptoms. Treatments like pain relievers, heating pads, and rest typically don’t do much to provide relief. This type of osteomyelitis occurs most often in older patients.
• Diabetic foot osteomyelitis - In patients who develop osteomyelitis of the foot due to a diabetic foot infection, symptoms may include bone pain, malaise, swelling, redness, or warmth in the affected area, as well as fever, sweating, and chills. If there is an open wound, drainage of pus may occur. Such infections may result in osteomyelitis of the toe or ankle.

General osteomyelitis symptoms

The following symptoms may present across all types of osteomyelitis:

• Pain at the site that becomes worse when pressing on the affected area or standing
• Deep bone pain
• Swelling, redness, and tenderness at the site
• Fever, chills, and sweating
• Malaise
• Drainage of pus from wounds or abscesses
• Loss of appetite
• Irritability (especially in infants who can’t express pain)

Osteomyelitis complications

Osteomyelitis can permanently damage bone and surrounding tissues and muscles, leading to chronic osteomyelitis. Fractures to the affected bone may occur. If the infection has spread to the tissues and muscles, abscesses — or pockets of pus — can end up seeping through the skin. People with chronic osteomyelitis can experience recurring abscesses, which may require professional draining. In children still growing, osteomyelitis can stunt bone growth.

Bone death (osteonecrosis) can occur if the swelling worsens to the point that it cuts off blood flow to the bone. Necrosis of the bone can lead to gangrene, which in turn can quickly cause sepsis, a severe infection of the blood. In very rare cases, this can result in amputation or loss of limb. In extreme untreated cases, life-threatening osteomyelitis complications can occur.