Bone and Soft Tissue Infection

Infections such as felon, paronychia and furuncle are common soft tissue infections and you will be at a higher risk of developing them if you are suffering from chronic diseases such as rheumatoid arthritis, diabetes mellitus, haemophilia, sickle cell anaemia and human immunodeficiency virus acquired immuno-deficiency syndrome (HIV-AIDS). Soft tissue infections are caused by the microorganisms such as bacteria, viruses and parasites. Infection may develop through a breach in your skin particularly puncture wound caused by a contaminated sharp object.

These infections won’t limit to the soft tissues instead may progress to bone infection. Therefore never neglect even a small cut on your finger as it could get worse and cause severe disability. These infections need immediate treatment without which they tend to be chronic. Early diagnosis, appropriate antibiotic treatment and surgical intervention, if necessary, can treat most of the infections and prevent further complications.

Infection of a bone is called osteomyelitis and is mainly caused by a bacterium Staphylococcus aureus. It occurs as a result of open fracture with the ends of bone piercing the skin, or by spread of infection from other parts of the body (pneumonia or a urinary tract infection), or a secondary bone infection in a chronic open wound. If osteomyelitis is left untreated, infection becomes chronic and interrupts the blood supply to affected bone gradually leading to bone death.

You can suspect an infection by the symptoms such as redness, swelling, heat and inflammation at the site of infection. You may also have pain, stiffness, reduced range of motion and pus drainage accompanied by fever and chills. If you have any of these symptoms consult your doctor immediately. Your doctor will perform physical examination and order diagnostic tests such as X-rays, MRI scans to check for the extent of bone and soft tissue damage. Further, blood tests may be done to identify the causative microorganism.

Treatment

Treatment for osteomyelitis includes the following:

• Drainage: If an abscess has formed, pus will be drained through needle aspiration procedure in which the fluid is withdrawn through the needle inserted into the affected area
  
  
• Medications: Appropriate antibiotics in the form of oral or intravenous formulations will be prescribed to clear the infecting bacteria from the bloodstream
  
  
• Splinting and cast immobilisation: The affected bone may be immobilised to help in healing and avoid further trauma
  
  
• Surgery: In severe conditions, bone infections are managed through open surgical procedure in which the necrosed bone and tissues are debrided away

Joint infections such as septic arthritis are also treated similarly with antibiotic medications and prompt surgical drainage. Repeated joint aspirations may be done.

Common skin and soft tissue infections include:

• Paronychia: Paronychia is a soft tissue infection that occurs around fingernails. It may occur after minor injury to the fingertip or nail manipulation
  
  
• Felon: Felon is one of the common infections in hand. It is the pus forming or non-pus forming infection of the fingertip pulp
  
  
• Impetigo: Impetigo is a bacterial skin infection and is more common in children suffering from eczema (atopic dermatitis) between the ages of 2 and 6 years. It is caused by bacterial entry into broken skin such as cuts, insect bites, or wounds
  
  
• Furuncle: Furuncle or a boil is a bacterial infection of the hair follicle and surrounding skin. Infecting organisms enter deep into the skin through the damaged hair follicles.
  
  
• Tenosynovitis: Tenosynovitis is the inflammation of the sheath (synovium) lining a tendon. Infection, injury, strain or overuse of the tendon may cause tenosynovitis. The tenosynovitis is often seen in the tendons of hands and wrists. Although other treatments are available for tenosynovitis, tenosynovitis caused by a cut in the hands or wrists needs emergency surgical treatment

Soft tissue infections may heal with warm water soaks and application of sterile dressing. Antibiotic ointments may be applied to the infected area or oral antibiotic medications may be prescribed. In some cases, infection may need to be drained under local anaesthesia to relieve the pain.

It is important to avoid infection from developing in the skin wounds and underlying soft tissues because it has the potential of spreading deep into the bones. When you injure yourself, take care of the wound by following these instructions:

• Control the bleeding, clean the wound with water and mild soap
• Keep dirt, hair, clothing or other objects away from contact with wound
• Do not remove foreign substance if embedded in the wound
• Use sterile dressing material to cover the wound
• Consult your doctor for further treatment