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Bone and Joint infection (3 questions)
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what is osteomyelitis
inflammatory process accompanied by bone destruction and caused by an infecting organism
clinical presentation of bone and joint infection
pain in affected area
swelling
fever
chills
decrease motion
what are the most important tools in obtaining cultures
isolate offending organism
bone biopsy
blood cultures
fluid culture
what is contiguous infection
reaches bone from adjoining soft tissue infection or direct inoculation
how does a contiguous infection normally occur
trauma
bone surgery
joint replacement
which comorbidity is usually associated with vascular insufficiency
diabetes
what are the bones affected in hematogenous infections
children; long bones -- tibia, femur
adults; vertebral
how is vertebral infection diagnosed
needle biopsy
likely organisms for newborns
s. aureus
strep
e. coli
likely antibiotic treatment for newborns
naf/oxacillin and cefotaxime
likely organisms to infect children <= 5 years of age and what antibiotics are used to treat
s. aureus
strep
naf/oxacillin or cefazolin
likely organisms to infect children > 5 yrs of age and what antibiotics are used to treat them
s. aureus
naf/oxacillin or cefazolin
regular adults with bone/joint MMSA infection should be treated with
naf/oxacillin or cefazolin
regular adults infected with p. aeruginosa should be treated with
cipro or ceftazidime +- tobramycin
postoperative adult patients should be treated with
naf/oxacillin or ceftazidime/cefepime
or
ticarcillin-clavulanate
patients with vascular insufficiency should be treated with
naf/oxa or cefazolin
PLUS
ceftazidime/cefepime
MRSA IV antibiotics
daptomycin
linezolid
MRSA oral antibiotics
clindamycin
linezolid
doxycycline
bactrim with rifampin
what is the min amount of tx for MRSA bone joint infection
8 weeks
duration of therapy for non MRSA acute and chronic bone and joint infections
4 - 6 weeks (acute)
6 - 24 weeks (chronic)
which pts cannot receive oral antibiotic therapy
adults with diabetes or PVD
what is the basic rule for patients with prosthetic joint infection
remove the device in 2 stage exchange
what are the most common microorganisms for immunocompromised patients
aspergillus
c. albicans
mycobacteria
spreading of which diseases can cause septic arthritis
osteomyelitis
hematogenous
direct inoculation
what is the appropriate duration of therapy for nongonococcal septic arthritis
2 - 3 weeks
what are the important therapeutic maneuvers for septic arthritis
appropriate abx
joint drainage
joint rest
what is the tx of choice for gonoccocal infection
ceftriaxone 7 - 10 days
may change to amoxicillin or doxycycline
Author
alvo2234
ID
244663
Card Set
Bone and Joint infection (3 questions)
Description
PT III exam
Updated
2013-11-06T23:24:45Z
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