Infections Flashcards
(27 cards)
What is Septic Arthritis?
Infection that finds its way into the joint
What is the risk of joint infection proportional to?
Degree of damage
-Undamaged: rare
-OA: slight risk
-RA: intermediate risk
-Prosthetic: greatest risk
What are the most common pathogens associated with Septic Arthritis?
Staphyloccus (40%)
Streptococcus (30%)
Gram negative rods (20%)
How does Septic Arthritis present?
Joint that is red, warm and immobile often with palpable effusion
Chills and fever
What is the best initial and most accurate test for Septic Arthritis?
Arthrocentesis
What is seen in synovial fluid for Septic arthritis?
Leukocyte count >50-100,000: mostly Neutrophils
Postive gram stain in 50% of gram (+) Bacilli
What is the best initial empiric treatment for Septic Arthritis?
Ceftriaxone and Vancomycin
What alternative therapies for Gram (-) Bacilli in Septic Arthritis?
Quinolones
Aztreonam
Cefotaxime
Piperacillin
Aminoglycosides
What are alternative drugs for sensitive Gram-Positive Cocci in Septic Arthritis?
Oxacillin, Nafcillin
Cefazolin
Piperacillin with tazobactam
What are alternative drugs for resistant Gram-positive cocci in septic arthritis?
Linezolid
Daptomycin
Ceftaroline
Vancomycin
How does Gonococcal Arthritis present?
Sexually active younger pt with polyarticular involvement, tenosynovitis and petechial rash
What is the best initial test to diagnose Gonococcal Arthritis?
Arthrocentesis
What is seen in synovial fluid analysis for Gonococcal Arthritis?
30-50,000 WBC
low Gram stain, cx results
How to reach maximum sensitivity when diagnosing Gonococal arthritis?
Culture diffuse sites: pharynx, rectum, urethra, cervix
What is the best empiric therapy for Gonococcal arthritis?
Ceftriaxone, Cefotaxime or Ceftizoxime
If a patient has recurrent GOnorrhea infection what should you test for?
Terminal Complement deficiency
What is osteomyelitis?
Infection of the bone
What organism is the most common cause of Osteomyelitis?
Staphylococcus Aureus
What is the best initial test for osteomyelitis?
X-ray
If x-ray is normal in suspected osteomyelitis what should you do next?
MRI
What ist he most accurate test for Osteomyelitis?
biopsy
What is ESR used for in osteomyelitis?
To Follow the response to therapy
What treatment is used for Osteomyelitis caused by sensitive Staphylococci?
Oxacillin, Cefazolin, Nafcillin or Ceftriaxone
What treatments are used for osteomyelitis caused by resistant Staphylococci?
Vancomycin, Daptomycin, Dalbavancin/Oritvancin (IV dose lasts 2-3wk)
