Infectious Diseases (PEARLS)
The NCCPA™ Musculoskeletal Content Blueprint infectious diseases (PEARLS)
| Acute and chronic osteomyelitis (ReelDx) |
Osteomyelitis is INFECTION OF BONE by pyogenic organisms
Acute osteomyelitis is most commonly seen in children with S. aureus as the most common organism
- Sickle cell disease - Salmonella is pathognomonic
Chronic osteomyelitis is most common in adults secondary to open injury of bone and surrounding soft tissue
- S. aureus is the most common organism (80%)
- Staph epidermidis in prosthetic joints
- Gram-negative pseudomonas in IVDU
Sources
- acute hematogenous spread most common in general - especially children
- direct inoculation from infection close to bone - trauma, surgery, prosthetic joint
- contiguous spread with vascular insufficiency
Diagnose with BONE ASPIRATION Gold Standard
Treatment: IV antibiotics for 4-6 weeks and at least 2 weeks of IV antibiotics
- Newborn (<4 months) - Group B Strep - nafcillin or oxacillin + 3rd gen cephalosporin
- > 4 months S. aureus - MSSA - Nafcillin + Ancef MRSA - Vancomycin or Linezolid
- Sickle cell - Salmonella - 3rd gen cephalosporin or FQ (Cipr)
- Puncture wound - Pseudomonas - Cipro or levofloxacin
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| Septic arthritis (ReelDx) |
Infection of JOINT CAVITY - most dangerous form of acute arthritis MEDICAL EMERGENCY
S. aureus is most common (40-50%) N. gonorrhea in sexually active young adults, streptococci
Diagnose with ARTHROCENTESIS WBC > 50,000
Treatment is based on gram stain- 2-4 week course of antibiotics - Arthrotomy with joint drainage
- Gram (+) cocci - Nafcillin (Vanco if MRSA) - Vanco or Clindamycin if PCN allergic
- Gram (-) cocci - Ceftriaxone
- Gram (-) rods - Ceftriaxone
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