126 - Osteomyelitis Flashcards
OM (osteomyelitis) may spread via __ pathway or as a result of an __ in a nearby tissue/__ wound.
hematogenic
infection
puncture
OM in elder patients is usually in the __, while in children the commonly affected areas are __
vertebrae
long bones
The most common area for OM is the __
vertebrae
The most common pathogen causing vertebral OM is __, followed by (3)
staph aureus
strep
G (-)
candida (IVDU)
The chronic form of OM is usually caused by: 3
TB
brucella
Typical clinical presentation of vertebral OM include- 3. The vertebrae most commonly involved are: __>__>__
back pain
fever > 38
neurological deficiency
lumbar>thoracic>cervical
Lab results of OM will show normal __, increased __ markers (__ is more specific together with __). Cultures will be positive only in -%. the gold standard imaging tests are__ and __, helping to locate __
WBC inflammatory ESR CRP 30-80 MRI CT abscess
Treating OM is done first with __. Surgical treatment is recommended only in the case of an infected __.
Abx
prosthetic
If the pain lingers even after __ is normalized, consider __/__.
CRP
osteonecrosis/spine instability
What is the recommended Abx for OM due to SA and MRSA?
nafcillin/oxacillin -> rifampin + levofloxacin
vancomycin->rifampin + levofloxacin/TMP-SMX
What is the recommended Abx for OM due to strep?
penicillin G/ceftriaxone
What is the recommended Abx for OM due to enterobacteria which is susceptible and resistant to quinolone?
ciprofloxacin
imipenem
What is the recommended Abx for OM due to pseudomonas?
cefepime/ceftazidime + aminoglycoside -> ciprofloxacin
or
piperacillin-tazobactam + aminoglycoside -> ciprofloxacin
What is the recommended Abx for OM due to anaerobes?
clindamycin
OM of long bones is caused by: 3
hematological pathway
trauma (open fracture)
post op
OM of long bones may appear even after __ years
50
Which the imaging test is most suitable for OM of long bones?
SPECT CT
What are the RF for foot OM? 5
peripheral neuropathy deformations vascular damage unstable diabetes injuries
In foot OM the cultures of the __ and __ might not match.
skin
bone
The test of choice for foot OM is __
MRI
What is probe to bone test?
examining by looking for and touching the bon
