Osteomyelitis (Exam 3) Flashcards
Osteomyelitis
Infection of the bone
Osteomyelitis is common with a digit distal to
AV fistula
Osteomyelitis
Severe infection of the bone - Bone marrow and surrounding soft tissue
What is it hard to treat osteomyelitis?
It is hard for the antibiotics to get into the bone
What is the most common infecting organism is osteomyelitis?
Staphylococcus aureus
Delayed identification of osteomyelitis can lead to:
Chronic pain
Infection + drainage
Loss of function
Amputation
Death
Osteomyelitis: Risk Factors
IV drug use
Diabetes
Immunosuppression
Hx of blood infection
Ulcer/chronic open wounds
Limiting spread of osteomyelitis can complicated by:
Malnutrition
Alcoholism
Liver Failure
How does bacteria gain entry?
Indirect (blood stream)
Direct (Open wound-Direct entry)
Acute Osteomyelitis
< one month in duration
Local and Systemic Manifestations
Acute Osteomyelitis: Local Manifestations
Contestant bone pain that worsens with activity / unrelieved by rest
Swelling - tenderness - warmth at site
Restricted movement of affect part
Acute Osteomyelitis: Systemic Manifestations
Fever and chills
Night Sweats
Restlessness
Nausea
Malaise
Chronic Osteomyelitis
> one month in duration or has failed to respond to initial antibiotics
Can be continuous and persistent (resulting from inadequate acute treatment) or (process of remissions and exacerbations)
Systemic manifestations are reduced
Chronic Osteomyelitis: More Common Signs
Constant bone pain
Swelling
Warmth at site
Osteomyelitis: Diagnostic Study
Bone / tissue biopsy to determine organism
Blood / wound culture
Increase WBC and Increase ESR
X-ray
Radionuclide bone scan
MRI
How long does it take before X-ray shows changes in osteomyelitis?
at least 10 days
Osteomyeltist: Treatment
-Vigorous/prolonged IV antibiotics (picc line)
Surgical Debridement
Some immobilization of affected limb (initially may be bedrest)
Pain control
