Infections Flashcards
What is the clinical presentation of acute BJI?
Pyrexia, systemic signs,
pain/swelling/redness
reduced mobility/movement of joint in flexed position
- in children they may not feed or play properly
Explain Systemic Inflammatory Response Syndrome (SIRS)
two or more of the following:
- Pyrexia of 90
- RR >20, PaCO2 12,000 or
How can Septic arthritis infection get in a joint space?
Haematogenous spread
Contigous spread (infected bone)
Direct inoculation (injection or trauma)
- Mainly MSSA, streptococci
How would you diagnose acute septic arthritis?
Blood culture if pyrexial
CRP, FBC, U&E, lactate, ESR etc.
Joint fluid aspirate
Crystals white cells and gram stain (gout, pseudogout)
Ultrasound, plain X-ray, MRI, CT, bone scan
How would you treat acute septic arthritis if the organism is Staph aureus?
IV Flucloxacillin (high dose)
How would you treat acute septic arthritis if the organism is H influenzae or Kingella (kids) ?
Ceftriaxone if they are under 5 years of age
What is Osteomyelitis?
Inflammation of bone and medullary cavity, usually long bones or vertabrae
What organisms can cause acute osteomyelitis?
MSSA or streptococci
What organisms can cause chronic osteomyelitis?
Myobacterium tuberculosis, pseudomonas aeriginosa, salmonella, brucella coliforms
How can Osteomyelitis spread?
Haematogenous
Contigous
Peripheral vascular disease associated
Prosthesis associated
Where is haematogenous spread most likely to occur in acute osteomyelitis?
Femur/tibia
How do you diagnose osteomyelitis?
Blood culture if pyrexial
bone biopsy,
emperic high doe flucloxacillin
What are risk factors for infection in prostethetic joints?
Rheumatoid arthritis
Diabetes
Malnutrition
Obesity
Where are coNS usually found?
As part of normal skin flora
How do you diagnose PJI?
Culture of tissue and bone
Blood culture
CRP, WCC
Radiological investigations
