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IOS 10 Exam 4

Skin/Bone/Soft tissue infections

QuestionAnswer
Cellulitis is a Primary infection of the skin that may extend to involve the subcutaneous layer caused by trauma or underlying lesion of poor circulation or altered immune function.
The most frequent pathogens in cellulitis are S. pyrogenes and S. aureus
Osteomyelitis is defined as An infection in the long bone which contains many hairpin turns
3 types of osteomyelitis Hemotogenous osteomyelitis, Contiguous, Vascular insufficiency
Septic arthritis is An infection or septic arthritis that has occured in the JOINT SPACE. Common disease and one of the most common causes of new cases of arthritis
Pathophysiology of cellulitis believed to originate from the skin and or oropharynx, as well as from contaminated needles, and diluents. Staph aureus and Streptococci most comon.
S/S of cellulitis Affected area feels hot, fever, chills or malaise, erythema and edema with poorly defined lesions. Tender lymphadenopathy is common
Osetomyelitis Pathophysiology (3 ways) 1. Hematogenous- vascular in long bone 2. Duration- Acute (1 day-week) or chronic 3. Anatomic location of the infection (medullary or superficial)
S/S of Osteomyelitis Pain, Swelling, fever, chills, malaise, erythema
Septic arthritis pathophysiology Infectious arthritis may result from the spread of an adjacent bone infection, direct contamination of the joint space or hematogenous
2 types of septic arthritis Non-gonoccal (monoarticular, fever, elevated WBC, decreased joint motion, joint swelling, pain. or Gonoccal signs- Fever, migratory POLYARTHRALGIA, tenosynovitis, dermatitis, swollen warm joints
Most common pathogens associated with general Cellulitis S. aureus and streptococci
Cellulitis most commonly associated with IVDA or DM Gram - and anaerobes
Most common organisms associated with Dog bites Pasturella meltocida, S. aureus
Most common pathogens associated with cat bites Pasturella multocida
Most common pathogens associated with humans anaerobes + aerobes
Most common pathogen associated with osteomyelitis S. aureus, E.coli
Most common pathogen associated with IVDA osteomyelitis Gram- , pseudominas, klebsiella, serratia, enterobacter
Most common pathogens associated with Non-gonoccal osteomyelitis S. aureus, streptococci
Factors that determine appropriate antibiotic selection Must cover staph and strep 7-14 days, based on seveity (out/inpatient), allergies, organ function, tissue penetration (not issue), Cost
Diabetic foot infections must be Broad Gram + - due to tissue ischemia, impaired immunity
Cellulitis Mild infection PO Dicloxacillin, cephalaxin, cephadoxil, PCN-bactrium or clarithromycin 1-2 weeks
Cellulitis Severe infection IV- Nafcillin, Cefazolin, PCN ALL: linezolid,levofloxacin, clarithromycin 1-2weeks
Cellulitis with suspected MRSA Mild Bactrim Severe Linezolid 1-2 weeks
Cellulitis with suspected polymicrobial Imipentem/cilastatin 1-2 weeks based on severity
Dog bite treatment Augmentin or Fluroquinolones or bacrim 3-5 days controversal treatment
Diabetic foot infections treatment Augmentin, Fluoroquinolone+clindamycin or metronadizole 1-2 weeks
Osteomyelitis treatment Gram + HIGH DOSE IV- Dicloxacillin, Cephalaxin, Fluoroquinolone 4-6 weeks Chronic 6-12 months
Chronic Osteomyelitis treatment Gram - (Pseudomonias) Fluroroquinolones (levo)4-6 weeks Chronic 6-12 months
Septic arthritis: treatment of Polymicrobials Zosyn, Augmentin, (pseudomonas) ceftazidine+ aminoglycosides 4-6 weeks or chronic 6-12 months
Risk factors for infection following human/animal bite if DM Location on hand or foot, scalp/face, puncutre wound, treatment delay> 12 hrs, Age > 50, Immunosuppression, alcholism, Vacular disease, edema
3 Types of Osteomyelitis Hematogenous osteomyelitis (children), Contiguous (hip fractures), Vascular insufficiency (DM, PVD)
Non-gonoccal treatment of septic arthritus is Nafacillin, clindamycin or is MRSA- Vancomycin 2-3 weeks
Gonococcal caused septic arthrisi treatment Ceftriaxone 2-3 weeks
Created by: liza001
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