Exam 3 - Bone and Joint Infections Bomkamp Flashcards
infection of the bone causing inflammation of the bone marrow and surrounding bone
a. osteomyelitis
b. septic arthritis
c. prosthetic joint infection
a. osteomyelitis
inflammatory reaction within the joint tissue and fluid due to a microorganism
a. osteomyelitis
b. septic arthritis
c. prosthetic joint infection
b. septic arthritis
infection of a prosthetic joint and joint fluid
a. osteomyelitis
b. septic arthritis
c. prosthetic joint infection
c. prosthetic joint infection
in which case would you do a bone sample/biopsy, commonly obtained via surgical intervention?
a. osteomyelitis
b. septic arthritis
c. prosthetic joint infection
a. osteomyelitis
in which case would you use joint aspiration with examination of synovial fluid to establish diagnosis and/or surgical intervention? (2 answers)
a. osteomyelitis
b. septic arthritis
c. prosthetic joint infection
b. septic arthritis
c. prosthetic joint infection
osteomyelitis general tx duration
a. 2-4 weeks
b. 4-8 weeks
c. 6-12+ weeks
b. 4-8 weeks
septic arthritis general tx duration
a. 2-4 weeks
b. 4-8 weeks
c. 6-12+ weeks
a. 2-4 weeks
prosthetic joint infections general tx duration
a. 2-4 weeks
b. 4-8 weeks
c. 6-12+ weeks
c. 6-12+ weeks
3 main pathways for osteomyelitis pathogenesis
-hematogenous spread
-contiguous spread
-vascular insufficiency
Microbe reaches bone via bloodstream
a. hematogenous spread
b. contiguous spread
c. vascular insufficiency
a. hematogenous spread
Microbe reaches bone from soft tissue infection or direct inoculation (e.g. puncture wound, trauma, surgery)
a. hematogenous spread
b. contiguous spread
c. vascular insufficiency
b. contiguous spread
(continuing from some other trauma or issue)
Microbe reaches bone from soft tissue infection; risk factors include diabetes mellitus and peripheral vascular disease
a. hematogenous spread
b. contiguous spread
c. vascular insufficiency
c. vascular insufficiency
which of the following is typically monomicrobial when it comes to osteomyelitis?
a. hematogenous spread
b. contiguous spread
c. vascular insufficiency
a. hematogenous spread
(the other two are polymicrobial)
most common pathogen for bone and joint infections
staph aureus
osteomyelitis radiologic findings standard of care
a. X-ray
b. CT
c. MRI
d. nuclear bone scan
c. MRI
two pillars to osteomyelitis tx
-surgical intervention
-antibiotic therapy
empiric IV antibiotic options for osteomyelitis, septic arthritis, and PJI (I did not put doses)
-cefazolin, ceftriaxone, cefepime
-zosyn, unasyn
-meropenem
-cipro or levo
+
MRSA coverage generally needed:
-vancomycin
-daptomycin
-linezolid
if a pt is on cipro or levo for empiric IV antibiotics, what drug should be added if anaerobic coverage is desired?
metronidazole
tx duration of vertebral osteomyelitis due to MRSA
a. 2-5 days
b. 1-2 weeks
c. 3 weeks
d. 6 weeks
e. 8 weeks
e. 8 weeks
tx duration of DFI: Complete resection of all infected bone/tissue
a. 2-5 days
b. 1-2 weeks
c. 3 weeks
d. 6 weeks
e. 8 weeks
a. 2-5 days
(think, if there is no more infected tissue at all, you don’t need abx very long)
tx duration of DFI: Resection of all osteomyelitis, soft tissue infection remains
a. 2-5 days
b. 1-2 weeks
c. 3 weeks
d. 6 weeks
e. 8 weeks
b. 1-2 weeks
tx duration of DFI: resection performed, osteomyelitis remains
a. 2-5 days
b. 1-2 weeks
c. 3 weeks
d. 6 weeks
e. 8 weeks
c. 3 weeks
tx duration of DFI: no resection
a. 2-5 days
b. 1-2 weeks
c. 3 weeks
d. 6 weeks
e. 8 weeks
d. 6 weeks
oral antibiotics for osteomyelitis due to streptococci (3)
amoxicillin, cephalexin, clindamycin (if susceptible)
oral antibiotics for osteomyelitis due to MSSA (5)
dicloxacillin, cephalexin, cefadroxil, TMP/SMX, linezolid
oral antibiotics for osteomyelitis due to MRSA (3)
linezolid, TMP/SMX, clindamycin (if susceptible)
oral antibiotics for osteomyelitis due to gram negative rods (2)
TMP/SMX, fluoroquinolones
we may consider the addition of ______ when using oral abx for streptococci, MSSA, MRSA, and GNRs
rifampin
