Osteomyelitis Flashcards
1
Q
What are the clinical presentation of osteomyelitis?
A
Depends on causes/ risk factors
+/- localized signs of inflammation
+/- fever
+/- bony pain
+/- tenderness
+/- aching (Common)
2
Q
What are the organisms that can cause osteomyelitis
A
- S aureus
- Salmonellae
- P aeruginosa
- Serratia
- S epidermidis
- May be polymicrobial (for immunocompromised patients)
3
Q
What diagnostic tests should be used for osteomyelitis
A
- Erythrocyte sedimentation rate and C-reactive protein (biomarkers for inflammation)
*elevated in most cases - Plain film X-ray
*early normal, then periarticular demineralization (around the joint, the bone is breaking down), then periostitis (extra layer of inflammation of the bone) - MRI, CT, bone scan
*more sensitive - Bone biopsy
- culture and sensitivity is required
*Except in hematogenous osteomyelitis and positive blood cultures
4
Q
What is the treatment for osteomyelitis
A
- Debridement of necrotic bone
- Antibiotics
- I&D of abscesses as necessary
- Oral vs IV
*Oral quinolone therapy for 6-8 weeks
*Parenteral administration (administered outside the digestive tract)
*Sometimes Start IV and then switch depends on organism
5
Q
What is the etiology of osteomyelitis
A
- Hemtatogenous spread/ dissemination (Originating in the blood or spread through the bloodstream)
- Invasion from contiguous tissue infection (spreads to adjacent tissues)
- Skin breakdown with vascular insufficiency
