Infections of Bones and Joints Flashcards
what organisms can predispose osteomyelitis?
- salmonella
- brucella
- s.epidermis
- h. influenzae
- E. coli
what predispositions can cause osteomyelitis?
- sickle cell disease
- travel/foreign born
- prosthesis
- children under 5 (rare in countries with Hib vaccination programme)
- UTI
which organisms are responsible for osteomyelitis?
- s. aureus
- s. pyogenes
- m. tuberculosis
what are preliminary investigations for osteomyelitis?
- fever
- WBC
- ESR
- CRP
what are investigations of osteomyelitis?
- blood culture
- x-ray
- MRI/CT/bone scan
- pus
- take 3 cultures, may be negative early on
- operative sample
what are the therapeutic regimens for osteomyelitis?
standard empirical
- flucloxacillin/fucidin
alternative empirical
- fucidin/erythromycin or rifampicin (ß-lactam allergy)
- ciprofloxacin (salmonella infection)
- isoniazid, rifampicin, pyrazinamide, ethambutol (TB)
drainage/removal of involucrum
what are the sites of septic arthritis?
- knee
- hip
- lumbosacral spine
what are conditions predisposing septic arthritis?
- rheumatoid arthritis
- injection of joint
- prosthetic joint
what are the causative organisms for septic arthritis?
- s. aureus
- s. pyogenes
- s. epidermis
- m. tuberculosis
- salmonella
- brucella
what are the diagnostic investigations for septic arthritis?
- blood culture
- joint aspirate
- joint x-ray
how is septic arthritis managed therapeutically?
standard empirical
- flucloxacillin/fucidin
alternative empirical
- fucidin/erythromycin or rifampicin (ß-lactam allergy)
what are examples of post- infectious arthritides?
- rheumatic fever
- rubella, meningococcus, yersinia
- salmonella, shigella, campylobacter, mumps
- reiter’s syndrome
what are symptoms/features of reiter’s syndrome?
- synovitis
- conjunctivitis
- sacroiliitis
- aortitis
- circinate balinitis
- keratoderma blennorrhagica
- HLA B27
- associated with clamydial infection
how do bones become infected?
- haematogenous spread
- local spread (septic arthritis)
- compound fracture
- foreign body
haematogenous spread to bones
- usually asymptomatic
- skin sepsis may be present (but usually absent)
- organisms settle ingrowing metaphysis
