Infections Flashcards
if you can see bone and there is signs of infection what is it?
Osteomyelitis
What is osteomyelitis?
inflammation of bone and medullary cavity, usually located in one of the long bones
Treatment of infection
Debridement
Antimicrobial
if chronic symptoms
Wait till you have had biopsy, blood and then treat
Retroscective data
group of people and gather data now in terms of what has happened to them in terms of treatment
What organisms are diabetic foot ulcers caused by?
Staph aureus
Streptococcus spp
Enterococcus spp
What should you avoid (unless your patient is septic)
EMPIRIC ANTIMICROBIAL
What do coat negative staph love
plastic/metal
Staphlococcus
aerobic
prodcuces enzyme inc coagulase
some strains produce toxins inc enterotoxin, SSST, PVL
If true penicillin allergy ( therefore can’t give fluclox) then what do you give?
Vancomycin
What is key with open fractures?
Early management is key (aggressive debridement, fixation and soft tissue cover)
A swab is not helpful unless..
you are asking a specific clinical question
What is the classic infection that causes sinuses of the bone
TB
What is the GOLD standard in haematogenous osteomyelitis
Bone biopsy
Who is haematogenous osteomyelitis common in?
Prepubertal children
PWID
Central lines/ dialysis, elderly
What is the epidermiology of PWID haematogenous osteomyelitis
Contiguous
Haematogenous
Direct innoculation
What is the cause of osteomyelitis pubis
urogynae procedures
What organisms - sickle cell osteomyelitis
Stpahlococcus aureus
salmonella
What is Gaucher’s disease
lysosomal storage disease
SAPHO and CRMO
Synovitis Acne Pustulosis Hyperostosis Ostteitis
Chronic
Recurrent
Multifocal
Osteomyelitis
What is the risk factors for clavicle osteomyelitis
Neck surgery
subclavian vein catheterisation an
Vertebral osteomyelitis
Staph aureus
can be TB
How can you be sure of verebral osteomyelitis
MRI
What is the treatment of vertebral osteomyelitis
Drainage of large paravertebral/epidural accesses
Antimicrobials for 6 weeks minimum
MRI increased if inc pain, increase in inflammatory markers or new anatomical signs
Skeletal tuberculosis (Pott's disease) Who gets it and what are the symptoms?
Often systemic symptoms
Vets
people who drink unpasteurised milk
Planktonic bacteria
Bacteraemia
Sessile bacteria
Phenotypic transformation of planktonic bacteria
Biofilm
Extracellular matrix
What does rifampicin do?
Helps to penetrate the biofilm ( only used alongside another treatment as risk of mutation too high)
in diagnosis of prosthetic joints
Culture-perioperative tissues
Blood culture
CRP
Rdiology
What is the ideal treatment of prosthesis infection
Remove prosthesis and cement
In people who are sexually active remember the organism
Neisseria gonorrhoea
What is the initial treatment if coagulase negative staphlococci
Vancomycin
What mimics septic arthritis?
Pseudogout
What is septic arthritis
Inflammation of the joint space caused by infection
What are the bacterial causes of septic arthritis
Staph aureus Streptococci Coag negative staph;ococci- prosthetic joins Neisseria gonorrhoea- sexually active Haemophilus influenza- pre-school
How do you diagnose septic arthris
Clinical picture- severe pain, red, swollen plus limited movement
Joint fluid- microscopy, C and S
Blood culture if pyritical
Exclude crystals
If treating septic arthritis with fluclox and the patient is less than 5 years old what other antibiotic do you add and why?
Ceftriaxone - for H influenza cover
Pyomyositis
Clostridial infection in contaminated wounds
soem site specific
Tetanus
gram + Strictly anaerobic rods forms spores ( which are found in soil) can have muscle spasms from stimulation such as noise or bright lights clinical-spastic paralysis
What is the treatment of tetnus
surgical debridement
antitoxins
Prevent by routine vaccination
What are the three causes of myositis
Viral
Protozoa
Fungal
