1 / 13

Good Morning It’s Friday!!!

Good Morning It’s Friday!!!. August 20, 2010. Osteomyelitis. 1% of pediatric admissions Neonates* Hematogenous spread* Tibia or femur 50% associated with septic joint* GBS & E.Coli Older children* Staph aureus * , Group A Strep, HIB, Salmonella (SCD) Rare joint involvement.

tacey
Download Presentation

Good Morning It’s Friday!!!

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Good MorningIt’s Friday!!! August 20, 2010

  2. Osteomyelitis • 1% of pediatric admissions • Neonates* • Hematogenous spread* • Tibia or femur • 50% associated with septic joint* • GBS & E.Coli • Older children* • Staph aureus*, Group A Strep, HIB, Salmonella (SCD) • Rare joint involvement

  3. Osteomyelitis • Direct invasion • Spread from focus • Trauma • Staph aureus • Puncture • Pseudomonas • Sole of sneaker • E. coli • Animal Bite • Anaerobes • Staph

  4. Osteomyelitis • Hematogenous* • Acute pain and decreased movement* • Possible swelling or redness* • Systemic Symptoms • Fever • Malaise • Irritability

  5. Osteomyelitis • Following trauma • Insidious, subacute onset • Localized pain, edema and redness • Absence of systemic symptoms • Chronic • Local findings may be absent or intermittent • Possible sinus tracts • Absence of systemic symptoms

  6. Osteomyelitis • Lab findings • Elevated or normal leukocyte • ESR/CRP elevated • Positive blood culture • 50%

  7. Osteomyelitis • Imaging • Plain films • 1-2 weeks* • Edema of surrounding tissues • Periosteal reaction • New bone formation • 2 weeks • Lytic lesions

  8. Osteomyelitis • Imaging* • Bone Scan • 2-3 days • Unclear location • Nonspecific • MRI • Specific • Abscess

  9. Pelvic Osteomyelitis* • Stats • Older children • Mean 8.1y • Boys > Girls • Ilium > ischium or pubis • Right > left • Increased risk for abscess formation • Late diagnosis • Staph aureus

  10. Osteomyelitis • Treatment* • High dose • Bactericidal levels in bone • 4-6 weeks • Staph or Strep • Oxacillin or naficillin • 1st or 2nd generation cephalosporins • Clindamycin • HIB • 2nd or 3rd generation cephalosporin

  11. Osteomyelitis • Treatment • Sickle Cell • 3rd generation cephalosporin • Other bugs to consider • Pseudomonas, anaerobes, GBS and E. coli

  12. Osteomyelitis • Complications • Recurrence • 5-10% are chronic • Abscess

More Related