osteomyelitis

Question 1

what is osteomyeltitis

Answer 1

inflammation in bone and bone marrow - often bacterial causation

Question 2

haematogenous osteomyelitis

Answer 2

pathogen is carried through blood and seeded in bone

most common mode of infection

Question 3

most common cause

Answer 3

staph aureus

Question 4

risk factors

Answer 4

open #
orthopaedic operations esp w prosthetic joints
diabetes esp diabetic foot ulcers
PAD
IVDU 
immunosuppresion

Question 5

presentation

Answer 5

fever
pain + tenderness
erythema
swelling

Question 6

Ix

Answer 6

x-ray
MRI 
bloods: WCC, CRP,ESR
blood cultures
bone cultures

Question 7

management -

Answer 7

surgical debridement

antibiotic therapy

Question 8

antibiotics

Answer 8

6wks of flucloxacillin

possibly with rifampicin or fusidic acid added for first 2wks

Question 9

alternatives to fluclox: penicillin allergy

Answer 9

clindamycin

Question 10

alternatives to fluclox: when MRSA

Answer 10

vancomycin or teicoplanin

Question 11

how long antibiotic course for chronic osteomyelitis

Answer 11

3+months