Exam 3 - Lecture 7 (bone and joint infections)

Question 1

infection of the bone causing inflammation of the bone marrow and surrounding bone

Answer 1

osteomyelitis

Question 2

inflammatory reaction within the joint tissue and fluid due to a microorganism

Answer 2

septic arthritis

Question 3

infection of a prosthetic joint and joint fluid

Answer 3

prosthetic joint infection

Question 4

most common pathogen for bone and joint infections

Answer 4

staph aureus

Question 5

are blood and tissue cultures needed for bone and joint infections?

Answer 5

yes

Question 6

osteomyelitis tx duration

Answer 6

4-8 weeks

Question 7

septic arthritis tx duration

Answer 7

2-4 weeks

Question 8

prosthetic joint infection tx duration

Answer 8

6-12+ weeks

Question 9

osteomyelitis develops in 3 main pathways

Answer 9

hematogenous spread
contiguous spread
vascular insufficiency

Question 10

most common pathogen for osteomyelitis

Answer 10

S. aureus + emphasis on covering Pseudomonas

Question 11

tx for osteomyelitis

Answer 11

surgery and abx equally as important

Question 12

empiric abx options for osteomyelitis

Answer 12

beta lactam, meropenem, levo or cipro
+
MRSA coverage

Question 13

osteomyelitis tx duration specific considerations (5 total)

Answer 13

vertebral osteomyelitis due to MRSA = 8 weeks
DFI related to osteomyelitis:
-complete resection of all infected bone/tissue = 2-5 days
-resection of all osteomyelitis, soft tissue remains = 1-2 weeks
-resection performed, osteomyelitis remains = 3 weeks
-no resection = 6 weeks

Question 14

PJI tx durations considerations

Answer 14

debridement and retention of prosthesis:
-pathogen directed tx w rifampin x 2-6 weeks
-oral abx tx w rifampin x 3-6 months
1 stage exchange:
-pathogen directed tx w rifampin x 2-6 weeks
-oral abx tx w rifampin x 3 months
2 stage exchange:
-pathogen directed tx w rifampin x 4-6 weeks
amputation with complete removal of infected bone/hardware:
-pathogen directed tx w rifampin x 24-48 hrs