Other Soft tissue infections Flashcards
Define Pyomyositis?
Infection deep in the striated muscle, often as an abscess.
Its often 2* to another infection
What causes pyomyositis?
Mostly Staph Aureus
Other bacteria, TB an fungi can cause it.
What factors can predispose you to pyomyositis?
Any immunocompromising disease:
- HIV
- Malignancy
- DM
- Liver Cirrhosis
- IVDA
As well as Rheumatological Disease
How does Pyomyositis present?
Fever, Pain and a woody induration of the muscle
Eventually septicaemia and shock
How do you test for pyomyositis?
If you get a patient with fever, pain in muscles and stiffening of muscles think infection.
Do a CT or MRI looking for muscle loss & abscesses as well as culture/gram staining for systemic infection
How do you treat pyomyositis?
Drain the abscess and give Abx
What is Septic Bursitis?
Infection of the cavities within synovial joints, mostly patellar or elbow joints
Often 2* to an adjacent skin infection
What causes septic bursitis?
Staph Aureus
What are the risk factors for septic bursitis?
Immunosuppression
DM
IVDA
Renal Disease
Alcoholism
Rheumatoid Arthritis
How does Septic Bursitis present?
Cellulitis, infection of adjacent deep dermis & subcutaneous fat.
Swelling & Warmth
Fever
Pain in the joint on movement
How do we test for septic bursitis?
Aspirate the synovial fluid for culture
Most are treated empirically with Abx
Define Infectious Tenosynovitis?
An infection of synovial sheats around tendons, generally in the flexor muscles and the hands
What causes infectious tenosynovitis?
Staph Aureus & Streptococci
A chronic infection can be due to mycobacteria or fungi
How is Infectious Tenosynovitis spread?
Penetrating trauma
How would Infectious Tenosynovitis present?
Mostly in the hands:
- Semiflexed position
- Erythematous Fusiform swelling (of a finger)
- Tender tendon
- Pain on extension
How do we treat Infectious Tenosynovitis?
Empirical Abx and a surgical review in case it requires surgical cleaning/removal of tissue
Whats the main organism behind IV catheter infections>
Staph Aureus
How does an IV catheter infection progress, tested for and treated?
Local SSTI -> Cellulitis -> Necrosis
It can seed into other areas e.g. endocarditis or osteomyelitis
Test with a blood culture after clinical diagnosis
Treat with 14 days Abx course + remove the cannula, express any pus and do an echo for endocarditis
How do we prevent IV catheter infections?
Remove unused catheters, otherwise change them every 72 hours.
Monitor patients for thrombophlebitis indicative of SSTI
USe aspetic method when isnerting the canula
What are the main organisms behind Surgical Site Infections?
Staph Aureus
E. Coli
Pseudomonas Aeruginosa
describe the classes of surgical site infections?
Class 1 = a clean wound that ets infected
Class 2 = Clean-contaminated wound (i.e. minor break in the surgical technique)
Class 3 = Contaminated wound (often a traumatic wound)
Class 4 = A dirty or infected wound of tissue that’s necrotic or devilatised
What factors predispose you to surgical site infections?
DM Smoking Obesity Malnutrition Steroids Staph Aureus Colonisation
Also shaving a surgical site or perioperative hypoxia
How do you manage a surgical site infection?
Culture from the site + Abx
