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Causes
By Mayo Clinic staffOsteomyelitis occurs when an infection develops in a bone or spreads to a bone from another area of your body. It's caused by bacteria or fungi. The infected bone may deteriorate and form a pocket (abscess) of pus in response to the infection. This may block blood supply to the bone. In cases of chronic osteomyelitis that last for years, the loss of blood supply may lead to death of the bone.
Your bones are normally resistant to infection. In order for osteomyelitis to occur, a situation that makes your bones vulnerable must be present. For instance, trauma to your bone, such as a fracture, or to the soft tissue around your bone, such as a puncture wound, gives infections a route to enter your bone or nearby tissue. You may also be vulnerable to infection if you have a condition that weakens your body's ability to fight an infection, such as HIV, diabetes or sickle cell anemia.
Osteomyelitis is divided into several types depending on where an infection begins and where it occurs. Types of osteomyelitis include:
- Infections that travel through the bloodstream. Infections that travel through the bloodstream (hematogenous osteomyelitis) affect only a small portion of adults, but affect the majority of children with osteomyelitis. Infections may begin as mild infections elsewhere in the body, such as an upper respiratory tract infection or urinary tract infection, and spread through the blood to a bone.
- Infections that occur after injury or surgery. Bone infections can occur after trauma (post-traumatic osteomyelitis), such as broken bones that break the skin (compound fracture) or open wounds to the surrounding skin and muscles. Post-traumatic osteomyelitis can also occur after surgery if metal pins, screws or plates are used to secure the broken bones. Open wounds offer easy access for bacteria to enter the bone or nearby tissue directly.
- Infections in people with poor circulation. Osteomyelitis that occurs in people with poor circulation, such as those with diabetes, usually begins with minor scrapes or cuts on the feet. Poor circulation (vascular insufficiency) impairs the body's response to infection. What begins as a small cut can progress to a deep ulcer that may expose deep tissue and bone to infection.
- Infection in the bones of the spine. Osteomyelitis that occurs in the spine (vertebral osteomyelitis) most commonly affects older adults and usually starts with an infection in the bloodstream, though it can also occur from trauma or surgery (post-traumatic osteomyelitis). A number of infections can cause vertebral osteomyelitis, including skin infections, respiratory tract infections, urinary tract infections, infections in the inner lining of the heart (endocarditis), infections in the mouth, and infections in areas where you receive drug injections.
