osteomyelitis Flashcards
Osteitis
inflammation of the cortex
osteomyelitis
inflammation of medullary canal
sequestrum
piece of dead bone floating in pus/inflammation
involucrum
heath of bone surrounding pus/inflammation
Cloaca
tract through involucrum
Brodies abscess
chronic abcess surrounded by sclerosis
Sclerosing OM of Garre
low grade inflammatory condition
Contiguous/direct extension
outside in spread
Hematogenous spread
inside out spread
How long before can be called OM?
> 6 months (weiland)
>6 weeks. one failed episode of tx (schauwecker)
Cerny mader penninck classification
Anatomic 1. medulary 2. superficial cortex 3. only cortex 4. cortex and medulary Physiologic A= Normal Bs=systemic risk Bl= local risk C= Tx worse than disease
Cerny mader penninck tx
stage 1: 2 wks IV + 2-4 weeks PO abx
Stage 2: debridement + 2 weeks IV
Stage 3&4: debridement + 4-6 weeks IV
OM best abx
doxy and cipro
IDSA tx recommendations
No residual infect: 2-5 days PO
Residual soft tissue: 2-4 wks oral
Residual bone: 4-6 weeks IV than oral
Residual dead bone > 3 months IV/oral
Cellulitis open wound
streaking=strept
none=staph
acute ulcer w out abx
Staph/strep
Chronic ulcer w out abx
staph/strep/Enterobacter
chronic ulcer + long cource abx
MRSA, enterobacter, corneybacterium, pseudomonas, gram - rod, VRE
Macerated ulcer
pseudomonus
polymicrobial
Necrosis/gangrene
resistant gram +, mixed gram -, anaerobes, polymicrobial
osteomyelitis +IVDA/hemolysis
s. aureus pseudomonas, enterobacter
OM + ulcer
gram neg
OM + SCA
salmonella
Immuno compromised infection
gram neg
septic bursitis
s aureus
white discharge
s epidermis
yellow discharge
s. aureus
infection after implant
s. epidermidis
