Infections

Question 1

What organisms commonly cause Osteomyelitis?

Answer 1

Staphylococcus aureus
Streptococcus pneumoniae
Escherichia coli
Pseudomonas
Salmonella - In patients with Sickle cell disease

Question 2

What are some of the risk factors for Osteomyelitis?

Answer 2

Vascular disease
Trauma
Sickle cell disease
Immunosuppression eg DM, Chemotherapy
*Children have a rich blood supply to the growth plate so commonly effects the metaphysis*

Question 3

What are some of the signs/symptoms of Osteomyelitis?

Answer 3

Pain
Tenderness
Erythema
Decreased ROM
Signs of systemic infection eg temperature

Question 4

What investigations can be done for a patient with suspected Osteomyelitis?

Answer 4

Bloods - Increased CRP, WCC, positive blood culture in some
X ray - takes 10-14 days to appear, haziness and decreased bone density, sub periosteal reaction
MRI - Best for sensitivity and specificity

Question 5

What is the management of a patient with Osteomyelitis?

Answer 5

IV Vancomycin and cefotaxime
Drain abscess
Analgesia

Question 6

What organisms commonly cause Septic arthritis?

Answer 6

Staphylococcus aureus
Streptococci pneumoniae
Gonococcus
Gram -ive bacilli

Question 7

What are some of the risk factors for Septic arthritis?

Answer 7

Pre existing joint disease
Prosthetic joints
Immunosuppression eg DM, Chemotherapy
Chronic renal failure

Question 8

What are some of the signs/symptoms of Septic arthritis?

Answer 8

Decreased ROM
Systemically unwell
Erythematous, swollen, tender joint

Question 9

What investigations can be done for suspected Septic arthritis?

Answer 9

Joint aspiration for microbe sensitivity
Bloods - Increased CRP, WCC, cultures
X-ray

Question 10

What is the management for Septic arthritis?

Answer 10

IV Vancomycin and cefotaxime
Splint joint
Physio after infection resolved
Can do joint wash out under GA

Question 11

What are some of the complications of Septic arthritis?

Answer 11

Osteomyelitis
Arthritis
Ankylosis: fusion

Question 12

What are some of the differentials for Septic arthritis?

Answer 12

Crystal arthropathy

Reactive arthritis

Question 13

What is Reiter’s syndrome (Now known as reactive arthritis)?

Answer 13

Arthritis, conjunctivitis and urethritis caused by a chlamydia trachomatis infection
Body responds to inflammation by attacking healthy tissue

Question 14

What is the management of Reactive arthritis?

Answer 14

Most people get better within 6 months

Symptomatic relief with NSAIDs, can have steroids or DMARDs if severe

Question 15

Define Cellulitis

Answer 15

Acute infection of the subcutaneous connective tissue

Question 16

What organisms commonly causes Cellulitis?

Answer 16

β-haemolytic Streps

Staph. aureus

Question 17

How does Cellulitis present?

Answer 17

Pain
Swelling
Erythema
Systemically unwell
May have lymphadenopathy

Question 18

What is the management of Cellulitis?

Answer 18

Oral ABx for 10-14 days eg Flucoxacillin, Clarithromycin, Clindamycin
If severe, IV ABx - Benzylpenicillin can add Ciprofloxacin and Clindamycin

Question 19

What are some of the complications of Cellulitis?

Answer 19

Abscess
Necrosing fasciitis
Facial cellulitis (Can be caused by sinusitis, can lead to meningitis if not treated)