Bone and soft tissue infection Flashcards
what is acute osetomyelitis common in
children
more in boys
history of trauma
have an immunocompromised disease
what is commonly the source of infection
haematogenous spread local spread infants-infected umbilical in children- boils in adults- UTI
what is the most common organism that causes it
staph aureus
HIV AIDS
strep pyrogenes
describe the pathology
common in long bones
starts at metaphysic, vascular stasis leading to venous congestion and arterial thrombosis. acute inflammatiion and bone necrosis
what are the clinical features of osteomyelitis
infant- minimal signs of very ill, failure to thrive, common around the knee
child- severe pain, fever, malaise
adult- seen in throacocolumnar spine, backache, UTI, elderly
what investigations would you do ?
FBC and WBC x ray aspiration ultrasound tissue or swabs
what is the treatment?
supportive treatment- pain and dehydration
rest and splint age
antibiotics for 4-6 weeks
surgery-aspiration of pus and access drainage
what is the cause of chronic osteomyelitis
may follow acute
can be due to an operation
immunocompromised
what organism causes chronic
mostly mixed
staph aureus, e.coli
what are the complications
chronically discharging
ongoing infection
squamous carcinoma
what is the treatment for chronic
long term antibitocis- gentamicin
amputation
specific osteomyelitis caused by TB
primary complex usually in the lung or gut
secondary spread
tuberculosis granuloma
marked thickening of the synovuim
what investigations would you do
Mantoux test FBC sputum culture chest x ray joint aspiration
what is the treatment
rifampicin
isoniazid
ethambutol 2 months 2/6
rifampicin and isoniazid 6 months
describe acute septic arthritis
septic arthritis is caused by a direct bacterial infection of a joint resulting in inflammation
