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basic micro stuff

Y2S1B1

Musculoskeletal DiseaseFeatures
Most common microbes that cause osteomyelitis staph aureus, (90% of acute peds cases) coagulase-negative staph
Less common microbes causing osteomyelitis strep, enterococcus, e. coli, serratia sp, anaerobes
Rare microbes causing osteomyelitis mycobacterium, dimorphic fungi, candida sp, asperigillus, mycoplasma, brucella, salmonella, actinomyces
Gram positive cocci staph, strep, enterococcus
Gram negative cocci neisseria (gonorrhoeae, meningitidis), moraxella, acinetobacter
Gram positive bacilli - Endospore formers bacillus, clostridium
Gram positive bacilli - Non-endospore formers: regular shape/stain Listeria, erysipelothrix
Gram positive bacilli - Non-endospore formers: Irregular shape/stain - acid fast 1. Non-acid fast - corynabacterium, ropionobacterium; 2. Actinomycetes - actinomyces, nocardia
Gram negative bacilli - aerobes Bordetella, Brucella, Francisella, Pseudomonas
Gram negative bacilli - obligate anaerobes Bacteroides
Gram negative bacilli - facultative anaerobes: lactose fermenting Citrobacter, Enterobacter, Escherechia, Klebsiella
Gram negative bacilli - facultative anaerobes: non-lactose fermenting - oxidase negative Salmonella, Shigella, Yersenia, Serretia, Proteus Morganella
Gram negative bacilli - facultative anaerobes: non-lactose fermenting - oxidase positive Haemophilus, Pasteruella
Clinical presentation of osteomyelitis localized pain, fever, tenderness to palpation over affected site; hematogenous spread; conitguous focus of infxn; draining sinus tract; X-ray bone erosion and subperiosteal bone deposition
Diagnostic approach for osteomyelitis blood culture (ID the bug); MRI for sinus tract; stain/culture aspirate/biopsy; x-ray - after 1wk shows new periosteal bone, metaphaseal bone destruction; If there's diagnostic doubt order a bone scan
Managing acute osteomyelitis bacterial microbials, surgical drainage if necessary
Managing chronic osteomyelitis long term high dose antibiotics; surgical removal of sequestrum/necrotic tissue/bone abscess
Antimicrobial therapy in osteomyelitis 1. b-lactams and vancomycin; 2. cephalosporins, penicillinase-resistant penicillins
Osteomyelitis in contaminated open fx (3-25% of fx) Staph and aerobic G- bacilli
Vertebral osteomyelitis, spondylodiskitis, epidural abscess hematogenous spread; S. aureus and coag-neg Staph; M. tubercuolsis and Brucella (endemic); G- aerobic and Candida (IVDA, immunosupp, post-op)
Acute Hematogenous Osteomyelitis long bones (tib/fib); S. aureus, Strep. pneumoniae, H. influenzae; kids, elderly, IVDA, catheters
Created by: bscaryp
 

 



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