Bone & Joint infections Flashcards
How can septic arthritis occur?
direct inoculation (trauma) haematogenous spread
How does septic arthritis present?
Hot, red, swollen monoarthritis
systemic signs of infection
if multiple joints are affected at the same time in septic arthritis, what should you investigate for?
Endocarditis
What investigations should be done for septic arthritis?
Full bloods
CRP
Blood culture
Management of septic arthritis?
Antibiotics +/- surgical washout
What is osteomyelitis?
infection of bone
give 2 organisms that can cause acute osteomyelitis?
Staph aureus
Streptococci
Give 2 organisms that can cause chronic osteomyelitis?
TB (in the spine)
E. coli
How do the organisms manage to infect the bone in osteomyelitis?
Haematogenous spread
Prosthesis
Peripheral vascular disease (slowing of blood flow helps bacterial growth)
How does osteomyelitis typically present?
Pain, swelling and erythema over the affected area
Low grade fever
Fatigue and malaise
What is the gold standard investigation for osteomyelitis?
Bone biopsy
management of osteomyelitis?
IV antibiotics - vancomycin until cultures come back to make it more specific
When is a prosthetic joint infection most likely to present?
late (>1 month after operation)
How does an early prosthetic joint infection present?
sepsis + warm joint with effusion
Causative organisms for early-presenting prosthetic joint infection?
Staph aureus
Causative organisms for late-presenting prosthetic joint infection?
Staph. epidermis
What helps staph. epidermis be more pathogenic in prosthetic joint infections?
the presence of the prosthesis
How do late-presenting prosthetic joint infections typically present?
persistent pain at the joint with prosthesis loosening
Management of prosthetic joint infections?
Debridement + antibiotics
What causes tetanus and how does it present?
Clostridium tetani - releases toxins
Toxin mediated illness that causes spastic paralysis
How do the toxins from clostridium tetani cause symptoms in tetanus?
Toxins prevent neurotransmitter release so muscles are “locked” - can’t relax so progresses to inability to breathe, swallow etc because diaphragm and other muscles cant move
Management of tetanus?
Vaccination
Surgical debridement + antitoxin
is osteomyelitis more common in adults or children in the absence of previous surgery?
More common in children
