Bone and Joint infections Flashcards
What are the principles of inflammation?
Rubor, calor, dolor, tumor, functio laesa
What are the most useful blood tests in infection?
CRP
PV
What are ocassionaly useful blood tests in infection?
Blood cultures
WBC
ESR
What are relevant infections in bones and joints?
Acute osteomyelitis Chronic osteomyelitis Septic arthrtitis Soft tissue infections Infected arthroplasty
How does acute osteomyelitis occur?
Mostly post-traumatic/ open fracture causes inoculation of bug
Who is most at risk for acute osteomyeltiis?
Children of immunosuppressed = haematogenous
What bacteria commonly cause actute osteomyelitis?
Staph aureus
Haemophilus in children
What occurs in chronic osteomyeltiis?
Bone abscess causes dead and dying bone aroun it (sequestrum)
What is septic arthritis?
From inoculation
Metaphyseal spread
Direct haematogenous
Commonly streptococcal septic arthrtis
What is the maintstay of treatment for cellulitis?
Cover staph and strep - fluxcloxacillin and benzylpenicillin
What are the principles of treatment of infection?
Biopsy and debriement
If there is pus, let it out
What investigations should be done to diagnose an infected arthroplasty?
CRP
Joint aspiration
Bone scan
X-ray
How sucessful is surgery in the control of infected arthroplasties?
Two stage revision 80-90% control of infection
Depends on the bug, the host and the quality of surgical excision
What prophylaxis can be done to prevent infected arthroplasties?
Clean air theatres - laminar flow Local antibiotics Systemic antibiotics Duration of surgery Quality of hand washing Theatre discipline
What antibiotics are given prophylacticaly in joint replacement surgery?
Co-amoxiclav
Flucloxacillin + gent
Clindamycin
Co-trimaxazole
