Osteomyelitis

Question 1

Most common organisms in age <4mos

Answer 1

• Staph aureus
• Enterobacter
• GAS
• GBS

Question 2

Most common organisms in age 4 mos to 40 years

Answer 2

• Staph aureus
• Kingella kingae
• H. influenzae
• Enterobacter spp.

Question 3

Most common organisms in adults:

Answer 3

• Staph aureus
• Enterobacter
• GAS

Question 4

Cierny Classification of Osteomyelitis

Answer 4

I: medullary
II: superficial (cortical)
III: localized
IV: diffuse with loss of structural bone properties

A: normal host
B: immunocompromised host
C: treatment is worse to patient than the infection itself

Question 5

does location of osteo in a long bone impact treatment prognosis?

Answer 5

metaphyseal disease heals better than diaphyseal disease

Question 6

Treatment of an infected tibial nonunion is:

Answer 6

nail removal, sinus tract excision, antibiotic nail placement, 6 weeks antibiotics.

Question 7

what are risk factors for spontaneous osteomyelitis of the sternoclavicular joint?

Answer 7

subclavian vein catheterization

chronic renal dialysis

Question 8

how fast should CRP decline after surgery?

Answer 8

should plateau and then decrease after day 2. may not decrease in the presence of a hematoma or infection.

should return to normal values 5-21 days following surgery

Question 9

does chronic antibiotic suppression of osteomyelitis always work?

Answer 9

failure rate is 30%

Question 10

what is quorum sensing

Answer 10

bacterial intercommunication to mature a biofilm and produce virulence factors
- occurs as a second step in film formation, following adhesion to substrate