osteomyelitis
-inflammation of the bone
septic arthritis
-inflammation of the joints caused by infectious agents
a
Infection spread through the blood.
a) hematogenous
b) contiguous
c) inoculation
b
Infection is acquired via adjoining tissue.
a) hematogenous
b) contiguous
c) inoculation
c
Which is usually a result of direct implantation; secondary to trauma or surgery?
a) hematogenous
b) contiguous
c) inoculation
vascular insufficiency due to: diabetes, PVD, pressure sores
What are the risk factors for Contiguous Osteomyelitis? (3)
puncture injury, trauma
What are the risk factors for Inoculation Osteomyelitis? (2)
prematurity, infection, ASCVD, sickle cell, T2DM
What are the risk factors for Hematogenous Osteomyelitis? (5)
long bones, joints, vertebrae
What are the typical sites of Hematogenous Osteomyelitis? (3)
femur, tibia, mandible
What are the typical sites of Contiguous Osteomyelitis? (3)
foot
What are the typical sites of Inoculative Osteomyelitis?
IV drug use, prosthetic joints, uncontrolled diabetes
What has led to an increase in Osteomyelitis? (3)
s.aureus, strep
Which bacteria are usually the cause of Hematogenous Osteomyelitis? (2)
staph, strep, pseudomonas, anaerobes
Which bacteria are usually the cause of Contiguous Osteomyelitis? (4)
tenderness, redness, pain, swelling
What are the symptoms of Osteomyelitis? (4)
ESR, CRP, WBC
Which labs do we look at in Osteomyelitis? (3)
vertebral; prosthetic joint
What locations in the body are there guidelines for treating osteomyelitis?
hold AB's until bacterial diagnosis
If a patient has Vertebral Osteomyelitis and they are stable, how do we proceed?
empiric AB's while waiting for cultures
If a patient has Vertebral Osteomyelitis and they are unstable, how do we proceed?
staph. aureus, strep, gonorrhea
What are common pathogens involved in Septic arthritis? (3)
d
A patient has been diagnosed with Septic Arthritis and the pathogen is Staph. Aureus; what do we treat them with?
a) clindamycin
b) ceftriaxone
c) doxycycline
d) vancomycin
e
A patient has been diagnosed with Septic Arthritis and the pathogen is streptococci; what do we treat them with?
a) clindamycin
b) ceftriaxone
c) doxycycline
d) vancomycin
e) either A or B
b
A patient has been diagnosed with Septic Arthritis and the pathogen is gonorrhea; what do we treat them with?
a) clindamycin
b) ceftriaxone
c) doxycycline
d) vancomycin
surgical management
What is essential in Prosthetic Joint Infections?
c
What is the most common pathogen in Prosthetic Joint Infections?
a) gonorrhea
b) streptococci
c) staphylococci
d) staph. aureus
add rifampin
How do we treat staphylococci-induced Prosthetic Joint infections?
cefepime
Which AB has the highest cancellous bone concentration?
3-4 weeks
How long does it take for bone to revascularize?
4-6 weeks; longer for MRSA
How long is the treatment duration?