Flashcards in Wounds / Soft tissue Injury/Joints/STD Deck (21)
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1
Most frequent pathogen isolated from plantar puncture wound osteomyelitis
Pseudomonas aeruginosa
**particularly when puncture goes through an athletic shoe**
2
Recommendation for use of prophylactic antiobiotics in puncture wounds
1. high risk patients (diabetics, immunocompromised)
2. Forefoot injuries (deeper)
3. Puncture through athletic shoes
3
Antibiotic choices for puncture wounds, when indicated
1. Cipro for athletic shoe punctures
2. Cefazolin, Cephalexin, Cefadroxil
3. Antistaph penicillins (oxacillin, dicloxacillin)
4. Azithromycin
5. MRSA - Bactrim or Clindamycin
4
Indications for primary suture closure of animal bite wounds
1. Face or scalp
2. Simple, no devitalized tissue, single layer
3. No underlying fracture
4. Host not immunocompromised
5
Pathogen most often causing sepsis etc in immunocompromised patients w animal bites
Capnocytophaga canimorsus
*covered by Augmentin*
6
"High risk" animal bite wounds
1. Cat or human bites
2. Livestock bites
3. Monkey bites
4. Puncture wounds
5. HAND or foot wounds
6. Heavily contaminated, older, or devitalized wounds
7. Signs of infection at first evaluation
8. Diabetic or immunocompromised patients
7
Catbite infection is often due to
Pasteurella multicida
*covered by Augmentin*
8
Treatment / prophylaxis for high risk bite wounds
3-5 day course of:
1. Augmentin for most
2. Cipro for fish bites
3. Azithromycin for bartonella (cat scratch)
**Penicillin allergic patients**
1. Doxycycline or Cefuroxime (Ceftin) for CAT bites
2. Clindamycin + Cipro for DOG bites
9
"cat scratch fever" caused by and treated by
Bartonella henselae
Azithromycin
10
Regional lymphadenopathy + mild constitutional sx developing 7-12 days after a cat bite or scratch
Cat scratch fever - bartonella henselae
Azithromycin
11
Pathogens associated with human bites
Staph and strep
Eikenella corrodens
*Prophylaxis with Augmentin*
12
Calcium pyrophosphate crystals,
yellow, rhomboid
positive birefringence
Pseudogout
13
1st line tx acute gout
NSAIDs 5-7days
Indomethacin 50mg TID
or naproxen
or Colchicine 0.6mg/h
14
1st line tx acute gout in renal impaired patienst
Prednisone
Narcotics
15
most common causes of viral arthritis in US
Parvovirus B19
Rubella
Hepatitis B
16
Traumatic hemarthrosis has a high association with
Ligamentous injury or an intra-articular fracture
17
arthritis, urethritis, and conjunctivitis
Reactive arthritis
18
most common STD
Chlamydia
19
Chlamydia + Gonorrhea tx
Azithromycin, 1 G PO single dose (Chlamyd) +
Ceftriaxone 250mg IM single dose (Gonorr)
** OK for pregnant women **
OR
Doxy 100mg PO BID x 7 days
20
Syphilis tx
Benzathine Penicillin G 2.4 million u IM single dose
**OK for pregnant women**
Doxycycline twice daily for 2 weeks may be used in penicillin-allergic patients
21
