Nursing homes need to anticipate the possible complications from bedsores in addition to the most expected consequences such as tenderness and swelling. One dangerous complication from severe bedsores (also called pressure ulcers) is the risk of infections – some of which may be life-threatening.

Bedsores occur when the flow of blood to the skin is limited causing bones and other body parts not to get the oxygen and nutrients they need. Nursing home residents are at risk of bedsores in areas of their bodies that don’t have enough fat or muscle, such as the spine, elbows, shoulder blades, hips, and heels.

Residents of nursing homes are at greater risk of bedsores than most people because many residents have difficulty moving and have dry, thin skin that isn’t very elastic. Nursing homes should routinely ensure that patients move on a regular basis. Staff members should routinely look for the signs and symptoms of bedsores.

What types of infections can bedsores cause?

Bedsores can cause cellulitis (a skin infection), septic arthritis (a joint infection), and osteomyelitis (a bone infection).

Cellulitis

Cellulitis, according to the Mayo Clinic, is a common but potentially serious bacterial skin infection that causes the skin to swell and become inflamed. Left untreated, cellulitis can spread to a nursing home resident’s lymph nodes and bloodstream – and become life-threatening. Cellulitis normally affects the lower legs but can affect the arms, face, and other parts of the body.

The symptoms include irritated skin, tenderness, pain, warmth, chills, fever, blisters, and skin dimpling. Residents with a fever, a tender rash, or a frequently changing rash should receive emergency medical care. People with a weakened immune system, certain skin conditions, and being overweight have an increased risk of developing cellulitis. Bedsores can cause cellulitis.

Left untreated, cellulitis can cause “bacteremia, endocarditis, osteomyelitis, toxic shock syndrome or sepsis.” In rare cases, cellulitis can spread to the deep layer of tissue called the fascial lining which is an extreme emergency condition.

The nursing home medical professionals may recommend antibiotics. The antibiotics should be taken until the prescription is completed. Wounds including bedsores should be washed daily. Ointments may be recommended. Wounds should be bandaged. The nursing home staff should look for the signs of infection – pain, pus, and irritation.

Hospitalization may be required if the resident isn’t responding to oral antibiotics, has a high fever, or the signs and symptoms of cellulitis are extensive.

Septic arthritis

Septic arthritis is a painful joint infection. The Mayo Clinic states that older adults have a higher risk of developing septic arthritis. Left untreated, nursing home residents who have bedsores may develop septic arthritis which can cause severe damage to the joint’s cartilage and bone. Treatment of septic arthritis involves using a needle or conducting surgery to drain the joint. The treatment normally also includes a course of antibiotics.

The symptoms of septic arthritis include difficulty using the joint. The joint may become warm, red, and swollen. Patients may have a fever. There are other symptoms if a resident has an artificial joint. There are various risk factors for septic arthritis including existing joint difficulties, artificial joints, medications that are being used for rheumatoid arthritis, fragile skin (such as is common with bedsores), and a weakened immune system.

Septic arthritis is diagnosed by blood tests, imaging tests, a joint fluid analysis, and possibly a specialized scan for prosthetic joint infections.

The treatments for septic arthritis include draining the joint and antibiotics. Other interventions may be required.

Osteomyelitis

According to the Cleveland Clinic, osteomyelitis is a painful infection of the bone that causes swelling. This infection (which can develop from bedsores) can cause bone damage and bone loss. Quick antibiotic treatment often works. Some patients need surgery “to drain abscesses or remove damaged bone.”  Osteomyelitis is caused by bacteria or fungi. Left untreated, this condition can cut off the supply of blood to the bone causing the bone to die.

Osteomyelitis is categorized as:

• The infection comes on suddenly, possibly with a fever and then pain in the affected area.
• The infection doesn’t go away with treatments causing bone pain and recurring pus. Some people with chronic osteomyelitis don’t have any symptoms.
• This type affects a resident’s spine causing chronic pain that worsens when the resident moves. “People who live in nursing homes, misuse intravenous drugs, or are on dialysis are more prone to spinal bone infections.”

Per the Cleveland Clinic, “osteomyelitis occurs when bacteria from nearby infected tissue or an open wound circulate in your blood and settle in bone, where they multiply. Staphylococcus aureus bacteria (staph infection) typically cause osteomyelitis. Sometimes, a fungus or other germ causes a bone infection.”

Some of the symptoms of osteomyelitis include warmth, tenderness, swelling, fever, yellow pus, loss of appetite, lower back pain, sweating and chills, vomiting and nausea, irritability, and painful movement.

Osteomyelitis is diagnosed through a physical exam. Possible tests include blood tests, a bone scan, X-rays, MRIs, CT scans, ultrasound, and a biopsy.

Possible complications include abscesses and bone death.

The treatments include antibiotics to kill infection-causing bacteria, antifungals, needle aspiration to drain fluid and pus from the abscess, and pain relievers such as NSAIDs. Possible surgical procedures include bone surgery and spine surgery.

The prognosis for osteomyelitis treatment improves if the infection is caught earlier and treatments are started sooner – which is why nursing homes need to conduct regular examinations of any residents who have bedsores – to look for any possible infections.

Prompt medical treatment is critical. Nursing homes that fail to provide timely and quality care for bedsores and bedsore infection may be liable for the resident’s personal injuries and any tragic deaths that occur – based on the nursing home’s abuse or neglect.

If you, a relative, or someone you know is a victim of infections or bedsores due to neglectful nursing home care, the elder abuse lawyers at Garcia & Artigliere are ready to help you assert your rights. Our lawyers have the experience and resources to help nursing home residents hold nursing homes accountable when they fail to prevent, identify, and treat bedsores and infections. Contact our firm to schedule a free consultation to discuss your rights. We have offices in Long Beach, Los Angeles, Louisville, Phoenix, and New Orleans.

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