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    Suggest treatment for chronic osteomyelitis

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Posted on Fri, 14 Jul 2017 in Brain and Spine
Question: Hello, I have spina bifida and lack of sensation from the hips down. Last year, I had an ischial pressure ulcer that was treated and closed at a local wound care center over 2.5 weeks. before I was discharged. Unfortunately, the wound had tunneled and I had a serious infection that included the bone. Long story short, I had multiple surgeries, wound vacs, a colostomy, a blood clot in my leg, 3.5 mos in hospitals and 8 months off from work (I am a research professor at a university). In October, I noticed swelling in my vulvar on the same side as the healed pressure ulcer. I saw my gynecolgist, who referred me to the surgeon to did the colostomy, who referred me to the plastic surgeon who closed the wound, (which was very deep by the time he got to it.) He said not to worry if not symptomatic.
The swelling continued slowly and by May was infected--a drain was inserted and I had IV antibiotics. The swelling lessoned but never totally resolved, and this month i have infection again. Another drain and more meds. Question: Is this likely to be chronic? Can osteomylitis be cured at this point? I am at a good teaching medical center, but am concerned that this was not treated for many months, and now is recurring. Thanks for any general advice you can give.
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Answered by Dr. Chobufo Ditah 1 hour later
Brief Answer:
This doesn't sound like osteomyelitis!

Detailed Answer:
Hi and thanks so much for this query.

This doesn't sound like chronic osteomyelitis. Yes, osteomyelitis can be conveniently treated through surgery and medical interventions. In your case, you probably have a chronic soft tissue infection. This has continued and not well treated. I will suggest that you get a culture to identify the exact germ and what antibiotic works best for it. This will ensure that treatment goes smoothly. Furthermore, I will not advocate for surgical closure. I will want to allow the wounds to heal inside out through granulation. Closure probably traps germs inside and is responsible for the repetitive infections a while after closure.

I hope this helps and guides. I wish you well. Feel free to follow up with me if need be.
Above answer was peer-reviewed by : Dr. Remy Koshy
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Dr. Chobufo Ditah

General & Family Physician

Practicing since :2009

Answered : 6252 Questions

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