Osteomyelitis in older adults: what to know

Osteomyelitis is an infection inside bone. In older adults, it may follow a wound, pressure injury, surgery, a fracture, or spread through the bloodstream from another infection. Fever may be absent or mild, so new confusion, reduced appetite, unusual tiredness, or a decline in walking can matter alongside pain, swelling, warmth, drainage, or a wound near the bone.

A clinician may examine the skin and wound, review circulation and sensation, and order blood tests or imaging. A sample from a wound or bone can help identify the organism and guide antibiotics. Diabetes, poor circulation, kidney disease, or reduced mobility can change the assessment and treatment plan.

Arrange a medical review for persistent bone pain, a non-healing wound, drainage, or new difficulty using a limb. Keep any wound covered as advised, avoid putting unplanned pressure on it, and take prescribed medicines exactly as directed. Do not use leftover antibiotics, because they can make later testing harder and may not treat the infection.

Treatment may include antibiotics, wound care, pressure relief, management of blood sugar and circulation, and sometimes removal of infected or damaged tissue. If bone has been lost after infection or surgery, a specialist may discuss [Bone Grafting](/treatments/trauma-and-fracture-care/bone-grafting/).

Seek urgent care for rapidly increasing pain or swelling, spreading redness, foul drainage, a very high or unusually low temperature, marked weakness, new confusion, fainting, or trouble breathing. An older person who suddenly cannot stand, walk, eat, or stay awake needs prompt evaluation even without a measured fever.

Ask which bone or tissue may be infected, what tests are needed, whether a culture is planned, how treatment will be monitored, and how medicines should be adjusted for kidney function or other conditions.