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21 Cards in this Set

  • Front
  • Back
what bones and parts of bones are usually osteomylitis in infants & children vs. adults.

hx of trauma?

signs & symptoms?
In infants and Children the
most frequently bones involved are the metaphyses of the long bones of the lower extremities (tibia, femur).

In adults it most commonly infects 2 adjacent vert.

There is a history of recent trauma in the area in around ¼ of the patients.

Symptoms include: inflammation, including edema
microbial causes of osteomylitis
Staphylococcus aureus is most common aerobe (G+)

Bacteroides spp. Are most common anaerobe
infectious arthritis
Acute inflammation
Loss of function
infectious arthritis
microbal causes in
Children less than 1 month
S. aureus
Group B Streptococcus
Gram negative organisms
infectious arthritis
microbal causes in Children under 2 years
Kingella kingae (G- rod) can account for as much as 50% of cases.

Staphylococcus aureus Haemophilus influenzae
infectious arthritis
microbal causes in Children 3-15
Staphylococcus aureus
Streptococcus pyogenes.
infectious arthritis
microbal causes in Adults under 30
Neisseria gonorrhoeae
infectious arthritis
microbal causes in Adults (all ages)
Staphylococcus aureus is by far the most common cause.
infectious arthritis
microbal causes in instrumentation or surgery of either the urinary or intestinal tract.
Gram-negative bacteria (Enterobacteriaceae and Pseudomonas)
more chronic infectious arthritis
microbal causes
Brucella spp. Mycobacterium tuberculosis, and atypical mycobacteria and fungi such as Sporothrix schenckii.
disseminated gonococcal infection with purulent arthritis
2 forms:
Triad of tenosynovitis, dermatitis, and polyarthralgias w/o purulent arthritis (often - synovial fluid cx)

Purulent arthritis without associated skin lesions
(often + synovial fluid culture)
Lyme Disease (Lyme Borreliosis)
Stages & symptoms
Stage 1. Localized Erythema migrans (EM malaise, fever, headache, fatigue, chills).

Stage 2. Disseminated. Weeks to months later, ms pain, followed by arthritis, neuro symptoms, and/or carditis.

Stage 3. Persistant. Weeks to years later, chronic skin, nervous system and/or joint abnormalities sometimes leading to frank chronic arthritis.
Lyme Disease
microbe etiology
Borrelia burgdorferi, a spirochete
signs & symptoms
Occurs in summer and fall

An acute viral infection characterized by sudden onset of pleuritic chest pain, fever, headache and generalized malaise.

Most common symptom is a sudden sharp paroxysmal pain over the lower ribs or sternum. It may last several seconds to a few minutes and the patient is remarkably symptom free between attacks.

Etiology- several Coxsackievirus B strains (enterovirus)
Mycetoma (maduramycosis, Madura foot)

clinical picture & etiology
a local, chronic, and progressive infectious disease of the skin, subcutaneous tissue, bone and muscle.

Clinical picture: swelling that is often grotesque and disfiguring, multiple draining sinuses, pus-containing granules

at least 20 species of actinomyces and higher fungi
Soft tissue infection clinical picture
Starts with contamination of a wound & anaerobic conditions
anaerobic cellulitis is not that severe, usually only involves the subcutaneous tissues

Anaerobic myonecrosis or classical gas gangrene is the next- worse stage - Incubation period 6 hours to 2-3 days then acute illness developes. There is an abrupt onset, rapid progression, early death
Cause of cellulitis and gas gangrene
(organism & toxins)
Clostridium perfringens Type A

It is a G+ bacilli anaerobe that produce exotoxins (alpha toxin or lecithinase C)
necrotizing fascitis-

clinical picture
sudden onset, often involves the extremities, toxic shock like symptoms

bacteremia and toxemia are prominant features and cause a 60% mortality rate
necrotizing fascitis-

group A streptococci
at what age can infection from isteomylits spread into jt space?
<1 and in adulthood
(between 1& adulthood it can't)
osteomylitis -- adjacent soft tissue infection?
in adults not usually in kids.