Bone and Joint Infections Tutoring

Slides:



Advertisements
Similar presentations
Septic Arthritis S. Shadmanfar.M.D Rheumatologist.
Advertisements

Septic arthritis Inflammation of a joint caused by a bacterial infection
Lecture 3 Antimicrobials and Susceptibility tests Dr. Abdelraouf A. Elmanama Islamic University-Gaza Medical Technology Department.
Sorting Out Antibiotics: A systematic approach to antibiotic selection Kenneth Alexander, M.D., Ph.D. Associate Professor of Pediatrics and Microbiology.
Septic Arthritis Pamela Gregory-Fernandez, PA-C SVCMC PA Education Program.
Clinical Cases Beta-Lactam Answers. Case 1 What antibiotic would you recommend for intravenous therapy in a 40yo BM with a Staphylococcus aureus (MSSA)
Risk Factors Corticosteroids Existing arthritis Articular infection Infection elsewhere DM Trauma None.
MUSCULOSKELETAL BLOCK PROF. HANAN HABIB & PROF A.M.KAMBAL DEPARTMENT OF PATHOLOGY KSU Microbiology of Bone and Joint Infections.
Bone & Joints Infections. Osteomyelitis Osteomyelitis is infection of the bone. Infections can reach a bone by traveling through the bloodstream, spreading.
Microbiology of Bone and Joint Infections (Osteomyelitis & Arthritis)
Common ID Syndromes March 2014.
Antibiotics 101 A review of common infections and their treatment For others, like me, who have a mental block against all things related to antibiotics.
Nosocomial E. coli Urine Isolates 1991 – Nosocomial K. pneumoniae Urine Isolates
Nosocomial E. coli Urine Isolates Nosocomial K. pneumoniae Urine Isolates
Therapeutics 3 Tutoring Exam 4 February 20 th, 2016 Lisa Hayes
DIAGNOSIS OF SEPTIC JOINT IN CHILDREN Sara Jane Shippee UW Orthopaedic Surgery, PGY-1 Seattle Children’s Hospital 11/1/2012.
ANA Testing Carrie Marshall 1/18/08. Septic Arthritis RRC R heumatology R esearch C enter.
MANAGEMENT OF NEUTROPENIC FEVERS IN CANCER PATIENTS Jerry Yu.
Using Nursing Home Antibiograms To Improve Antibiotic Prescribing and Delivery Training Slides for Nursing Home Nurses Comprehensive Antibiogram Toolkit.
Septic Arthritis Dr.noori/Rheumatologist
BONE AND JOINT INFECTION Dr.Syed Alam Zeb Orthopaedic Unit HMC.
Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved. Musculoskeletal Disorders.
HAP and VAP Guidelines Update
Therapeutics 3 Tutoring
Drug Induced Liver Disease Tutoring
Therapeutics 3: Antibiotics Tutoring
Therapeutics 3 Tutoring
Endocarditis Tutoring
Infection in Bone and Joint
Infectious Disease I: Bone and Joint Infections
Benjamin Westley MD FAAP FACP
CNS Infection Tutoring
Sexually Transmitted Infection Tutoring
Sepsis Tutoring By Alaina Darby.
Endocarditis: Treatment
Epidemiology, general characteristics and clinical evolution
Liver Disease tutoring Part 1
Antimicrobial Resistance at GLA
More Antibiotics Tutoring
Therapeutics 3: Antibiotics Tutoring
By: Wajidah Abdul-Khabir PGY-2
Liver Disease tutoring Part 2
Allie punke pharmcokinetics Allie punke
Therapeutics 3: Antibiotics Tutoring
FEVER WITHOUT LOCALIZING SIGNS
Therapeutics III Tutoring February 10th, 2016
More Antibiotics Tutoring
WCH / Pediatrics Pharmacy Department Pediatric Dosing Recommendations
Osteomyelitis An acute or chronic infection of the bone and bone marrow.
NOSOCOMIAL ANTIBIOTIC RESISTANT ORGANISMS
The Role of the Microbiology Laboratory in AMS programs
Infectious Disease I: Bone and Joint Infections
More Antibiotics Tutoring
Community Acquired Pneumonia Tutoring
SEVERE BACK PAIN AFTER BELOW KNEE AMPUTATION- NOT ALWAYS MECHANICAL!
Prof. hanan habib Department of pathology college of medicine ksu
Prof. hanan habib Department of pathology college of medicine ksu
Septicemia And Septic Shock Overview Almataria Teaching Hospital, Nasser Institute Cairo, Egypt Dr. Mamdouh Sabry MD. Ain Shams, PhD. France Consultant.
Andrea Guyot MD FRCPath MSc DTM&H DipHIC
Introduction to Antimicrobial Stewardship: Bugs and Drugs
The Tulane-Lakeside NICU “First Choice” Antimicrobial Guide
CLINICAL PROBLEM SOLVING
Infectious arthritis nebras abu abed.
Prof. hanan habib Microbiology unit
CURRENT CONCEPTS REVIEW OSTEOMYELITIS IN LONG BONE BY LUCA LAZZARINI,MD ET ALL THE JOURNAL OF BONE AND JOINT SURGERY, 2004 PAGE
Infectious Disease I: Bone and Joint Infections
A Good Walk Spoiled.
Empiric antibiotic therapy
Peritonitis treatment algorithm.
Presentation transcript:

Bone and Joint Infections Tutoring Alaina Darby

JT is a 46 yo WM who presents with pain and swelling in his leg after injuring it last week. Which test would be most beneficial to determine if he has osteomyelitis? Three Phase Bone Scan Gallium-67 MRI X-ray A… potentially C

JT is a 46 yo WM who presents with pain and swelling in his leg after injuring it last week. What lab values would you most expect to find if it is osteomyelitis? WBC 15,000 with right shift ESR 15 mm/hr CRP 40 mg/L Temp 99 F B

JT is a 46 yo WM who presents with pain and swelling in his leg after injuring it last week. He can still walk on it. How would you classify him using Cierny Mader Staging? Bs Bl Bls C D

JT is a 46 yo WM who presents with pain and swelling in his leg after injuring it last week. He can still walk on it. You find out that he was recently diagnosed with DM after noticing excessive urination and tingling in his fingers. How would you classify him now using Cierny Mader Staging? Bs Bl Bls C C

Cierny Mader Factors Systemic Generally LARGE! Local Generally small Nutrients Organs Decreased O2 Immune system (and comorbidities) Age Generally LARGE! (Big Picture things) Local Lymph/vessels Scarring/fibrosis Nerves Tobacco Generally small

JT is a 46 yo WM with DM and DMPN who presents with pain and swelling in his leg after injuring it last week. The doctor diagnoses him with osteomyelitis. The infection started in the skin and worked its way into the bone. Which of the following is the most likely cause for this patient? Hematogenous osteomyelitis Contiguous osteomyelitis with generalized vascular disease Chronic osteomyelitis Contiguous osteomyelitis without generalized vascular disease B

JT is a 46 yo WM with DM and DMPN who presents with pain and swelling in his leg after injuring it last week. The doctor diagnoses him with osteomyelitis. The infection started in the skin and worked its way into the bone. The infection has not reached the medulla. What Stage of Cierny Mader would this be? Stage 1 Stage 2 Stage 3 Stage 4 B

JT is a 46 yo WM with DM and DMPN who presents with pain and swelling in his leg after injuring it last week. Which of the following would be the least likely pathogen in this patient? S. aureus Pseudomonas S. epidermidis S. pyrogenes D

JT is a 46 yo WM with DM and DMPN who presents with pain and swelling in his leg after injuring it last week. Which of the following would be the best empiric treatment? Cefazolin + Nafcillin Cefepime + Nafcillin Ceftriaxone + Nafcillin Ceftazidime + Zosyn B

JT is a 46 yo WM with DM and DMPN who presents with pain and swelling in his leg after injuring it last week. You give him Cefepime + Nafcillin. Considering his DM, what might you want to add? Zosyn Clindamycin Ciprofloxacin Tobramycin B

JT is a 46 yo WM with DM and DMPN who presents with pain and swelling in his leg after injuring it last week. Cultures from his bone biopsy come back with S. pneumonia. What antibiotic should he receive? PCN-G Vancomycin Ampicillin Ceftriaxone A

JT is a 46 yo WM with DM and DMPN who presents with pain and swelling in his leg after injuring it last week. Cultures from his bone biopsy come back with PCN-intermediate S. pneumonia. What antibiotic should he receive? PCN-G Vancomycin Ampicillin Ceftriaxone D

JT is a 46 yo WM with DM and DMPN who presents with pain and swelling in his leg after injuring it last week. Cultures from his bone biopsy come back with PCN-resistant S. pneumonia. What antibiotic should he receive? PCN-G Vancomycin Ampicillin Ceftriaxone B

Cultures from a bone biopsy come back with Enterococcus Cultures from a bone biopsy come back with Enterococcus. What antibiotic would be least likely to work? PCN-G Vancomycin Ampicillin Ceftriaxone D

Cultures from a bone biopsy come back with S. aureus Cultures from a bone biopsy come back with S. aureus. What antibiotic would be least likely to work? PCN-G Vancomycin Nafcillin Ceftriaxone A

Cultures from a bone biopsy come back with S. aureus Cultures from a bone biopsy come back with S. aureus. It is determined to be MRSA. How should you treat? PCN-G Vancomycin Nafcillin Ceftriaxone B

Cultures from a bone biopsy come back with S. aureus Cultures from a bone biopsy come back with S. aureus. It is determined to be MRSA. How should you treat if you wanted to keep them on the same medication when released as an outpatient? Bactrim Linezolid Daptomycin Vancomycin B

Cultures from a bone biopsy come back with S. aureus Cultures from a bone biopsy come back with S. aureus. It is determined to be MRSA. How should you dose the Vanc for a 70 kg patient? 2.1g LD, 210mg Q12h MD 2.1g LD, 160mg Q12h MD no LD, 100mg Q12h MD no LD, 160mg Q12h MD C

Cultures from a bone biopsy come back with S. aureus Cultures from a bone biopsy come back with S. aureus. It is determined to be MRSA. How should you dose the Vanc for a 70 kg patient? 2.1g LD, 2.1g Q12h MD 2.1g LD, 1.6g Q12h MD no LD, 1g Q12h MD no LD, 1.6g Q12h MD C

Cultures from a bone biopsy come back with Pseudomonas Cultures from a bone biopsy come back with Pseudomonas. How should you treat? Cefazolin + AMG Ceftazidime + AMG Ceftriaxone + AMG Cefotetan + AMG B

LK is a 24 yo WF who presents with pain in multiple joints LK is a 24 yo WF who presents with pain in multiple joints. What is the most likely pathogen? Gonorrhea S. aureus E. coli Fungal A

LK is a 24 yo WF who presents with pain in multiple joints LK is a 24 yo WF who presents with pain in multiple joints. How should she be treated? Ceftriaxone for 2-3 weeks Ceftriaxone for 1 week Cefazolin for 2-3 weeks Cefazolin for 1 week B

Which of the following is most indicative of septic arthritis vs inflammatory arthritis in synovial fluid? Drastically elevated WBCs Low viscosity Yellow color Opaque fluid A

JF has RA and presents with joint pain JF has RA and presents with joint pain. Labs reveal WBC of 55K and PMNs 80%. What is the most likely pathogen? Gonorrhea S. aureus E. coli Fungal B