MSK infection Flashcards
What is osteomyelitis?
An infection of the bone
Should you give empiric antibiotics for osteomyelitis?
Not unless septic. Wait for cultures to come back first and treat specifically.
What are the six main forms of osteomyelitis?
Open fractures/direct inoculation Diabetic/Vascular Hematogenous spread Vertebral osteomyelitis Sickle Cell Osteomyelitis Gaucher's Disease
When do you suspect osteomyelitis of an open fracture?
When there is non-union and poor wound healing
What organisms most commonly cause open fracture osteomyelitis?
S. Aureus and aerobic gram -ive
How do you treat open fracture osteomyelitis?
Aggressive debridement
Fixation
Antibiotics
What is the standard course of antibiotics for osteomyelitis?
6 weeks of antibiotic appropriate in organism
Why do diabetics get osteomyelitis?
Because of increased blood sugar and stasis
How do you diagnose diabetic osteomyelitis?
Probe to bone and culture
What organisms most commonly cause diabetic osteomyelitis?
Polymicrobial
How do you treat diabetic osteomyelitis?
Debridement
Flucloxacillin and doxycycline/metronidasol
What groups are prone to haematogenous osteomyelitis?
Prepubescent children
PWID
Central lines
What organisms cause haematogenous osteomyelitis?
S. Aureus
Strep
Unusual pathogens: Pseudomonas and candida etc
What is distinctive about haematogenous osteomyelitis?
Can get it in odd places like pubis and clavicle
What is Sickle Cell osteomyelitis?
Sickle Cell sufferers are more susceptible to OM and septic arthritis
What organism commonly causes Sickle Cell osteomyelitis?
Salmonella
Why is it important to know about Gaucher’s disease?
Because it can mimic OM but is sterile
How does vertebral osteomyelitis present?
Fever Insidious pain Neuro signs Raised inflammatory markers Epidural or subdural abscesses
What groups are susceptible to vertebral osteomyelitis?
As haematogenous spread same as haematogenous in addition to those with a history of TB.
Which organisms commonly cause vertebral osteomyelitis?
TB and S. Aureus
How do you treat vertebral osteomyelitis?
Drain abscesses
Antibiotics
What factors increase your chance of developing a prosthetic joint infection?
RA
Obesity
Malnutrition
Diabetes
What are the two methods of developing a prosthetic joint infection?
Direct inoculation at time of surgery
Hematogenous seeding
When is hematogenous infection of a prosthetic likely?
If it occurs under a month after operation
