Infections Flashcards
what are staphylococci?
gram positive cocci in clusters
what are the two main groups of staphylococci?
coagulase positive
coagulase negative
name a coagulase positive staph
staph aureus
name a coagulase negative staph
staph epidermis
what is osteomyelitis?
inflammation of the bone and medullary cavity
where does osteomyelitis usually arise in a bone?
the head of the bone as this is where the greatest blood supply is
what are common causes of osteomyelitis in new borns and children?
s aureus
group B strep
what is the most common cause of osteomyelitis in adults?
staph aureus
how is osteomyelitis managed?
debridement
antimicrobials
what investigations are done for osteomyelitis?
bloods
imaging
bone biopsy
what is the gold standard investigation for osteomyelitis?
bone biopsy
what is spondylodiscitis?
infection of the disc space
how is vertebral osteomyelitis managed?
drain abscesses if present
antimicrobials for at least 6 weeks
what are the three types of prosthetic joint infection?
early
chronic
haematogenous
how is prosthetic joint infection diagnosed?
culture
CRP
imaging
how is prosthetic joint infection managed?
ideally remove prosthesis
antibiotics
re implant
what is septic arthritis?
inflammation of the joint space due to infection
how is septic arthritis diagnosed?
joint fluid for culture
x-ray
MRI
what is rubor?
redness
what is calor?
heat
what is dolor?
pain
what is tumor?
swelling
what is functio laesa?
loss of function
what is the most common cause of acute osteomyelitis?
staph aureus
what is the most common cause of acute osteomyelitis in children?
haemophilus
what investigations should be done for chronic osteomyelitis?
plain XR
MRI
how is cellulitis managed?
flucloxacillin and benzylpenicillin
what is osteomyelitis?
inflammation of the bone + medullary cavity
where does osteomyelitis usually arise and why?
at the head of a long bone
has the greatest blood supplu
how is osteomyelitis managed?
debridement
antimicrobials
what investigations are done for osteomyelitis?
bloods - CRP
imaging
what is the gold standard method of taking a sample in osteomyelitis?
bone biopsy
how are open fractures managed?
urgent aggressive debridement
fixation
soft tissue cover
name two common causes of infected open fractures
s aureus
gram - bacteria
what classification system is used to suggest how likely infection is in open fractures?
gustilo classification
what are the risk factors for osteomyelitis in patients with diabetes?
previous foot ulcers
neuropathy
foot deformity
vascular disease
what patient groups can be affected by haematogenous osteomyelitis?
prepubertal children
PWID
central lines
elderly
where in the body can osteomyelitis affect PWID?
often in unusual sites - SCJ, sternocostal joints, SIJ, pubic symphysis
what unusual pathogens may cause osteomyelitis in PWID?
pseudomonas
candida
eikenella corrodens
TB
what is the most common cause of osteomyelitis in dialysis patients?
s aureus
what organisms cause osteomyelitis in patients with sickle cell?
staph aureus
salmonella
what can osteomyelitis lead to in patients with sickle cell?
septic arthritis
what is SAPHO?
synovitis acne pustulosis hyperostosis osteitis
affects adults
what is CRMO?
chronic recurrent multifocal osteomyelitis
affects kids
how do SAPHO and CRMO present?
raised inflammatory markers lytic lesions on X-rays fever weight loss malaise
what is spondylodiscitis?
disc space infection
what things can increase risk of vertebral osteomyelitis?
epidural abscess PWID IV site infections GU infections STI post op bacteraemia
how does vertebral osteomyelitis present?
fever
insidious pain + tenderness
neurological symptoms
raised inflammatory markers
how long should antibiotics be given for vertebral osteomyelitis?
minimum 6 weeks
when should MRI be repeated in diagnosed vertebral osteomyelitis?
unexplained increase in inflammatory markers
increasing pain
new signs/symptoms
what comorbidities can increase the risk of prosthetic joint infection (PJI)?
RA diabetes cancer CKD obesity lymphoedema
what drugs can increase the risk of PJI?
corticosteroids
TNF inhibitors
DMARDs
what are the three types of PJI?
early
chronic
haematogenous
when does early PJI present?
1-3 months post op
acquired during surgery or directly after
name the most common cause of early PJI
S aureus
what is the most common type of PJI?
chronic
name some common cause of chronic PJI
cutibacterium
corynebacterium
s aureus
how does haematogenous PJI present?
abrupt onset
very unwell
name two common causes of haematogenous PJI
s aureus
gram negatives
