Osteomyelitis

Definition

Osteomyelitis is an infection of the bone, most commonly caused by Staphylococcus aureus. It may be acute or chronic and reaches bone via hematogenous spread, contiguous infection, or direct inoculation (surgery, trauma).

Risk Factors

• Open fractures
• Diabetes (foot ulcers)
• Peripheral vascular disease
• Immunosuppression
• Hemodialysis
• IV drug use

Signs and Symptoms

Bone pain (severe, worse with movement), fever, chills, local warmth/swelling/erythema, drainage (if sinus tract forms), elevated WBC, ESR, CRP.

Diagnosis and Treatment

MRI (most sensitive), bone biopsy with culture (gold standard). Treatment: long-term (4 to 6 weeks) IV antibiotics, often through PICC line. Surgical debridement for chronic osteomyelitis or implant infection.

Nursing Interventions

Administer antibiotics through PICC; teach line care (pain management). Immobilize affected limb. Encourage nutrition (protein, vitamin C). Monitor for complications: chronic infection, sepsis, pathologic fracture.

NCLEX Relevance

Long-term IV antibiotics via PICC.