musculoskeletal infections Flashcards
late features of necrotizing fascitis?
crepitus, bullae, ‘dishwater pus’, sepsis
initial features of necrotizing fascitis?
swelling, edema, disproportionate pain
type 1 necrotizing fascitis
polymicrobial: non-A strep, enterobacteria, anaerobes
type 2 necrotizing fascitis
“flesh eating”: group A b-hemolytic strep
type 3 necrotizing fascitis
marine vibrios: vibrio vulnificus
type 4 necrotizing fascitis
MRSA
necrotizing fascitis tx?
broad-spectrum antibiotics, surgical debridement; amputation
osteomyelitis
infection of bone, bone marrow
sequestra
DEAD BONE with surrounding granulation tissue
involucrum
periosteal NEW BONE
most sensitive MONITOR of the COURSE OF INFECTION in children?
CRP
shows changes in bone, bone marrow BEFORE xray?
MRI
osteomyelitis tx?
empirical tx, organism-specific antibiotics, surgery
most common infecting organism?
S. aureus
characteristic organism in sickle cell anemia?
salmonella
populations at high risk for chronic osteomyelitis?
immunosuppressed, diabetic, IV drug users
chronic osteomyelitis tx?
(NO empirical tx) culture-based IV antibiotics, debridement (and/or amputation)
Brodie’s abscess (usually in metaphyses)
SUBACUTE osteomyelitis
most commonly affected by Brodie’s abscess?
femur, tibia
characteristic feature in TB?
destruction in BOTH SIDES of joint
common etiology of septic arthritis?
hematogenous
moat common infecting agent in IV drug users?
Pseudomonas
septic arthritis tx?
empirical antibiotics (S. aureus most common) THEN organism-specific
most common pathogen associated with implants?
Staph epidermidis
most SENSITIVE (but NOT specific) indicator of infection?
ESR
1st step in TJA infection tx?
implant (and cement) removal
