Infectious Disease Flashcards
what are the 5 cardinal signs of cellulitis?
rubor (redness) tumor (edema) dolor (pain) calor (heat) functio lasea (loss of function)
what is red streaking caused by inflammation of lymphatic channels draining the site of infection called?
lymphangitis
how would you describe an open lesion?
record depth, size, shape, tissue or debris within lesion
what is fluctuance?
fluid beneath surface of skin which may be an abscess or hematoma
what is crepitus?
feeling of creptus is created by subcutaneous air or gas
*creptus w/ S/S is considered a surgical emergency
what is transient bacteremia?
bacteremia that happens on daily basis
what is intermittent bacteremia?
septic foci seeding the blood
what is continuous bacteremia?
bacterial endocarditis
what are the limits of blood culture protocol?
- need large volume of blood >20cc
- expensive
- can take up to 5 days to grow
- usually 3 sets (aerobic and anaerobic) are drawn 30 min. apart
what are the guidelines for admitting a patient with infection to hospital?
- high fever >101 F
- high WBC > 13,000
- systemic infection or sepsis
- failure to respond to outpatient therapy
- need IV to administed parenteral agent
- debridement requiring general anesthesia
- systemic disease
when is surgical intervention indicated for cellulitis?
not indicated unless there is an abscess
what kind of infections cause cellulitis?
usually Gram + infection
what are the 2 mechanisms by which an infectious agent enter bone?
- hematogenous- seeding thru blood stream from distant source
- external or contiguous force- from adjoining soft tissue or direct implementation
what are the pathophysiology steps of osteomyelitis?
sequestrum
involucrum
cloaca
what is sequestrum?
as infection progresses within bone, segments of necrotic bone are isolated from viable bone
what is involucrum?
outer cortex of bone violated with elevation of periosteum and stimulation of new bone to wall off infection
what is cloaca?
new bone formation violated releasing infection into soft tissue
hematogenous osteomyelitis occurs where in children? what about in elderly?
children- affects metaphyseal region of rapidly growing long bones
elderly- vertebrae
what is the most common single organism infection that causes hematogenous osteomyelitis?
Staph aureus
which organism is the cause of hematogenous osteomyelitis in neonates?
group B strep
which organism is the cause of hematogenous osteomyelitis in children under 2?
H. influenza
describe the anatomic type of classification (Cherny and Mader classification) for osteomyelitis.
type 1: medullary osteo
type 2: superficial osteo
type 3: localized osteo
type 4: diffuse osteo
describe the physiologic class of classification for osteomyelitis.
A-host: good immune system and delivery
B-host: compromised locally (BL) or systemically (BS)
C0host: no treatment, or tx is worse than disease itself
what is the gold standard for diagnosing osteomyelitis?
bone biopsy and bone culture ***
describe radiographic findings of osteomyelitis.
30-50% bone destruction
-radiographic findings lag 2 weeks
chronic osteomyelitis with sinus tracts is associated with what cancer?
squamous cell CA
what is the gold standard for treating puncture wounds?
debridement and irrigation
*antibiotics cannot compensate for improper wound care
which region is most likel to get osteomyelitis?
forefoot (zone 1)- metatarsal neck distally
describe the Waldvoegel classification.
acute (initial episode) - based on how people acquire osteomyelitis: hematogenous, secondary to contiguous focus, or associated with vascular insufficiency
chronic (recurrent)
What is the most common isolated organism from puncture wounds?
staph aureus
if there is OM after a puncture wound, then what is the most common organism isolated?
pseudomonas
