Osteomyelitis Flashcards
What is Osteomyelitis?
infection of the bone
What are the 2 subtypes of Osteomyelitis?
Haematogenous
Non-haematogenous
What is the most common cause of Osteomyelitis?
Staphylococcus aureus
4 features of haematogenous osteomyelitis
Results from bacteraemia
Usually monomicrobial
Most common form in children
Vertebral osteomyelitis is the most common form of haematogenous osteomyelitis in adults
4 RFs for haematogenous osteomyelitis
Sickle cell anaemia
IVDU
Immunosuppression due to meds or HIV
Infective endocarditis
3 features of non-haematogenous osteomyelitis
Results from contiguous spread of infection from adjacent soft tissues to bone or from direct injury/ trauma to bone
Often polymicrobial
Most common form in adults
3 RFs for non-haematogenous osteomyelitis
Diabetic foot ulcers/ pressure sores
Diabetes mellitus
Peripheral arterial disease
What is the most common cause of Osteomyelitis in Sickle Cell anaemia patients?
Salmonella
Sx of osteomyelitis
Non specific
Pain at site of infection (absent/ mild if peripheral neuropathy)
+/- Localised: : point tenderness, swelling, redness, warmth
+/- Systemic: malaise, fever
Imaging modality of choice for diagnosis of osteomyelitis
MRI
Initial Ix for osteomyelitis
FBC, CRP, ESR
Blood cultures: +ve if haematogenous
Plain XR: r/o ddx
Which investigation is confirmatory for osteomyelitis?
Bone biopsy + culture
Perform unless characteristic imaging features of osteomyelitis and +ve blood cultures
.
Describe management of peripheral osteomyelitis (methicillin susceptible)
IV Flucloxacillin
If pen allergy: IV Ceftriaxone
+/- pseudomonas cover
Describe management of peripheral osteomyelitis (MRSA)
IV Vancomycin
+/- pseudomonas cover
Describe management of cerebral osteomyelitis
Refer to ID + spinal surgeon
IV Vancomycin + Ceftriaxone
+/- surgery
