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Thread: possible bone infection

  1. #11

    Rybread

    I gather from what your saying is your pressure sore would not heal?
    Can this be the most tell talltale sign that osteo is there?
    I believe the abscess i had would of healed alot quicker if it was not packed with wrong stuff. Also the pressure sore i had sept.26, 2005 healed in about 2 months. Then around march 1, 2006 everytime i sat in my chair i would get violent spasms, about april 1 i was in bed and really cold, i went on my side and pus broke though about 3 inches from the old pressure sore.
    so the bottom line for me is i think at some point i should see the infectious disease doctor. what is scary is alot of people here are saying there is no way of know if youm have osteo.

  2. #12
    From what I understand, bad pressure sores start under the skin, near the bone, and work their way out towards the skin then break open. Once you have the sore in a spot you'll be much more susceptible to getting them in that same spot again, even if you had surgery, so you need to be even more careful with it once it's healed. I'd say if you can't get a sore to heal, especially if it's gotten to stage three or four, there's a good chance that the bone is infected. Make sure to see a plastic surgeon who has experience in dealing with pressure related issues to find out for sure. Once you do get this all figured out, get a wheelchair seating evaluation to make sure you're on the right cushion because everything will be different on the way you sit and you need to make sure that you're doing weight shifts well enough and there's not too much pressure in one spot. Sometimes Roho's aren't the right cushions, or there are several different kinds of Roho's that may benefit more than others.
    C-5/6, 7-9-2000
    Scottsdale, AZ

    Make the best out of today because yesterday is gone and tomorrow may never come. Nobody knows that better than those of us that have almost died from spinal cord injury.

  3. #13
    Senior Member lunasicc42's Avatar
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    They took Anthony down at 7am this morning for another bone scan and injected him with something and then did the scan again about 4 hours later. Then infectious disease dr. started Anthony on Meropenem for 6 weeks. I didn't get to talk to him and the nurse said she thinks they are treating him like he has the bone infection but still waiting for the bone scan results from today. They also attached the wound vac to three wounds earlier today.

  4. #14
    I know that it is tough going through this. You are doing a good job being an advocate for Anthony. And it sounds as though he is beginning to head in the right direction.

    Yes, osteo is hard to diagnose sometimes. IV antibiotics are the main way to try it. To answer your question re: how they know if the infection is in the bone or tissue - they look at the cells that they have retrieved. Bone cells look different from muscle cells.

    Given that it has taken so long to not heal, I think that a betting person wound bet that he has osteo. Until that gets cleared up, the wound can not heal correctly.

    Ask as many questions as you can - leave a pad in a variety of places so that you can write them down and not forget them. There is no such thing as a dumb or stupid question!

    CKF

  5. #15
    Senior Member lunasicc42's Avatar
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    yes we got a definite answer from the infectious dr. today it is in the bone on his left hip. He did get his J tube in today and we are going home tomorrow!!!! not that i'm happy about the infection but we are going home it has been 22 days in the hosp. He looks good with the tube out of his nose and we can tell he feels much better

  6. #16
    Good luck- keep us posted on how both of you are doing!
    CKF

  7. #17
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    Quote Originally Posted by SCI-Nurse
    Osteomyelitis often causes no symptoms, but we usually assume that if the pressure ulcer exposed bone, that the bone is infected. We never do a flap until AFTER the osteomyelitis is treated, so our procedure would be to do the needle biopsy for tissue culture either during a surgical debridement, or by itself, then start a course of IV antibiotics based on the culture (usually 6 weeks), and only then do the flap. Meanwhile we would often use the VAC.

    There are no known contraindications to use of the VAC over osteomyelitis. We do it all the time. It will not heal the wound, but may make the eventual incision for the flap smaller down the road.

    (KLD)
    So I have read a lot about how a VAC is not very effective with an infection or osteomyelitis. After antibiotics, how do we know if the infection or osteomyelitis is gone. I have a early stage of osteo that didn't show up on xrays but did on an mri.

    Once the infection is gone wouldn't the wound VAC kick in? Or does the osteo permanently make the VAC less effective on that particular wound.

  8. #18
    Quote Originally Posted by walkanotherday
    So I have read a lot about how a VAC is not very effective with an infection or osteomyelitis. After antibiotics, how do we know if the infection or osteomyelitis is gone. I have a early stage of osteo that didn't show up on xrays but did on an mri.
    I had the same question about how we know if the infection is gone after the antibiotics. The infectious disease dr. that diagnosed it in the hospital dropped him after we got home and told me to follow up with his primary care dr. Primary ordered a blood test and also said the radiologist report was kinda iffy and said that if there was in infection it would show up in the blood work. nothing showed up in the blood work. so we just let it go. we also saw his orthopedic dr. yesterday and i mentioned all this to him and said you really should'nt worry about a bone infection unless the wound is closed? Anyway in our circumstances I don't think Ant even had a bone infection. but to answer your question i have had so many different answers i have no idea, sorry.

    I was told an MRI is not the proper way to detect a bone infection.

    Here is a link that helps. The first item about diagnosing it is the best way I've heard. http://www.ecureme.com/emyhealth/Ped..._Infection.asp
    Cindy Waters
    mom to Anthony, right c5, left c4 (24yo)
    injury march 2003

  9. #19
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    waters, it's funny. I'm pretty sure NONE of my blood cultures came back with ANY bug at all. It was only through wound cultures.

    From what I hear, the X-ray is the first test for bone infection, but if you can see it from an X-Ray, it's already really bad. My X-rays came back negative.

    My MRI report said there was evidence of early stage or mild osteo.

    I heard that they might just do another MRI to confirm the osteo is gone. I'll have to ask my infectious disease doctor next time.

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