Infections Flashcards
which bones are most often affected by adult osteomyelitis
long bones
what is continuous osteomyelitis
adjacent site of infection
which organism is most common in osteomyelitis in children
haemophilus
risk factors for adult osteomyelitis
vascular insufficiency, chronic ulcer, diabetes, open fracture,sickle cell, Gaucher’s disease
which organism is most common in osteomyelitis in diabetic adults
polymicrobial
what is SAPHO/CRMO adult osteomyelitis
osteomyelitis in >1 site
type of osteomyelitis in PWID
contiguous or haematogenous
most common infecting organisms in adult osteomyelitis in PWID
staph, strep, pseudo, candida, corrodens, TB
most common infecting organism in adult myelitis in PWID who lick needles
corrodens
causes of haematogenous osteomyelitis
child, PWID, central line, dialysis, immunosuppressed, old
most common infecting organisms in haematogenous osteomyelitis
staph then strep
aetiology of vertebral osteomyelitis (spondylodiscitis)
PWID, IV, GU
investigations for vertebral osteomyelitis (spondylodiscitis)
normal WCC, get MRI, biopsy, abscess drainage
presentation of vertebral osteomyelitis (spondylodiscitis)
months back pain, only 50% fever
what is Potts disease
Skeletal TB
do patients with skeletal TB always have pulmonary TB
<1/2 pulmonary TB
area affects by skeletal TB
spans 2 vertebral bodies
presentation of skeletal TB
back pain, no systemic symptoms
most common infecting organisms in osteomyelitis from infected arthroplasty
coag –ve staph
then s. aureus, propionibacterium acnes (upper limb contaminant)
pathology of osteomyelitis from infected arthroplasty
microbe biofilm on joint
investigations for osteomyelitis from infected arthroplasty
multiple perioperative tissue cultures + bloods + CRP + bone scan + XR
antibiotic for coag -ve osteomyelitis from infected arthroplasty
vanco
most common infecting organisms in septic arthritis
mainly s. aureus
then strep, neisseria gonorrhea, viral
antibiotic for septic arthritis
flucloxacillin
antibiotic for septic arthritis if under 5 y.o.
flucloxacillin + ceftriaxone
pathology of chronic osteomyelitis
bone abscess surrounded by sequestrum (dead/dying bone) & involucrum (new bone)
what is a brodie’s abscess
sclerotic margin with osteoclytic lesion, found in chronic osteomyelitis
investigations for chronic osteomyelitis
+ve XR & MRI
+- +ve CRP
what is osteitis pubis
osteomyelitis from urogynae procedure/ aseptic from surgery
method of innoculation in osteomyelitis of clavicle
neck surgery, subclavian catheter
1st investigation for osteomyelitis
CRP, PV
investigation for direct confirmation of osteomyelitis
bone biopsy best for deep 7 day culture
investigations for indirect conformation of osteomyelitis
MRI best
Less useful; WCC, ESR, XR, technetium scan, CT
treatment of osteomyelitis
debridement, 6 wk fluclox, gram –ve;
treatment of osteomyelitis if fluclox allergy
vancomycin, PO switch to doxy
antibiotic for osteomyelitis if gram -ve infecting organism
gentamycin IV/ or doxycycline PO
example of pyomyositis
tetanus
tetanus pathology
spore, gram +ve anaerobic rod, neurotoxin
tetanus presentation
spastic paralysis, lock jaw
tetanus diagnosis
spore drumstick shape culture
tetanus treatment
debride, antitoxin, support, booster vac, penicillin/ metron
presentation of pyomyositis
severe pain, erythema, bullae
infecting organisms in pyomyositis
bacterial 90% staph (PWID), viral (HIV, CMV, rabies), protozoa, fungal
