UW osteomyelitis 03-01 (1) Flashcards
UW. healthy kids. Mo?
S. Aureus
UW. sickle cell kids. mo?
S aureus
Salmonela spp
Uw. healthy kids, empiric therapy is Low MRSA likelihood?
nafcillin/oxacillin OR cefazolin
Uw. healthy kids, empiric therapy is HIGH MRSA likelihood?
Clindamycin OR Vancomycin
UW. sickle cell kids. empirics Tx?
for S aureus - as in healthy kids
PLUS
to cover salmonela = third generation cephalo (eg ceftriaxone, cefotaxime)
UW. why kids with sickle cells incr. risk for osteomyelitis?
Impaired blood flow of sickled cells through narrow metaphyseal vessels causes microinfarctions that act as a nidus for infection.
UW. ALSO, sickle patients probably asplenic => more susceptible to encapsulated mos.
.
UW. Salmonela gram?
gram negative organism
UW. empiric in sickle cell patients should cover both, S aureus and salmonela.
.
UW. why clindamycin/vanco alone is not sufficient in sickle cell patients?
it covers only S aureus, but does not cover salmonella
UW. what abs need to cover salmonela?
third-cephalosporin (eg ceftriaxone, cefotaxime)
UW. why alone gentamicin would not be sufficient in sickle cell patient?
It covers only salmonela;
does not cover S. aureus
UW. table. spread?
hematogenous
UW. table. CP? 3
fever, irritability
Limited function (eg limp)
Bony tenderness, swelling
UW. table. Dx? labs
elevated ESR, CRP, WBC
+ blood culture
UW. table. Dx? imaging
xray - normal;
DO MRI
UW. table. Dx? definitive
bone biopsy/culture
UW. table. Tx?
in healthy kids - antistaphylococal (eg vanco)
UW. what part of bone is seeded with S aureus?
metaphysis of long bones
UW. in case was kid with osteomylitis + second cousin has sickle. mos? Tx?
jeigu pats vaikas neturi sickle cell symptoms = tai gydyti kaip sveika vaika, tik S aureus.
