Osteomyelitis - Revision history

Aidan at 17:13, 27 September 2024

2024-09-27T17:13:42Z

← Older revision		Revision as of 17:13, 27 September 2024
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	**[[Acute osteomyelitis]] (1 to 2 weeks) versus [[chronic osteomyelitis]] (3 to 6 months), though this classification is not necessarily helpful		**[[Acute osteomyelitis]] (1 to 2 weeks) versus [[chronic osteomyelitis]] (3 to 6 months), though this classification is not necessarily helpful
	**Etiology and location, including the [[Osteomyelitis with orthopedic hardware\|presence of orthopedic hardware]] or [[Prosthetic joint infection\|joint prosthesis]]		**Etiology and location, including the [[Osteomyelitis with orthopedic hardware\|presence of orthopedic hardware]] or [[Prosthetic joint infection\|joint prosthesis]]
	**Cierny-Mader classification based on area of bone involvement~~<ref>~~		**Cierny-Mader classification based on area of bone involvement[[CiteRef::cierny2003th]]

	Cierny G, Mader JT, Penninck JJ. A clinical staging system for adult osteomyelitis. Clinical Orthopaedics and Related Research. 2003;(414):7–24. doi: [https://doi.org/10.1097/01.blo.0000088564.81746.62 10.1097/01.blo.0000088564.81746.62]</ref>
	***Type I: medullary		***Type I: medullary
	***Type II: superficial		***Type II: superficial

Aidan: /* Oral Antimicrobials */

2023-03-03T17:29:20Z

Oral Antimicrobials

← Older revision		Revision as of 17:29, 3 March 2023
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	\|[[amoxicillin]] 500 mg PO bid to tid		\|[[amoxicillin]] 500 mg PO bid to tid
	\|-		\|-
	\|[[penicillin]] VK 500 mg PO bid to ~~tidO~~		\|[[penicillin]] VK 500 mg PO bid to tid
	\|}		\|}

Aidan at 15:16, 31 January 2023

2023-01-31T15:16:37Z

← Older revision		Revision as of 15:16, 31 January 2023
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	== Background ==		== Background ==
			*Inflammation of the bone which involves the medullary cavity, in comparison to osteitis (a distinction made on MRI but not clinically relevant)
	*Classified by:		*Classified by:
	**[[Acute osteomyelitis]] (1 to 2 weeks) versus [[chronic osteomyelitis]] (3 to 6 months), though this classification is not necessarily helpful		**[[Acute osteomyelitis]] (1 to 2 weeks) versus [[chronic osteomyelitis]] (3 to 6 months), though this classification is not necessarily helpful
	**Etiology and location, including the [[Osteomyelitis with orthopedic hardware\|presence of orthopedic hardware]] or [[Prosthetic joint infection\|joint prosthesis]]		**Etiology and location, including the [[Osteomyelitis with orthopedic hardware\|presence of orthopedic hardware]] or [[Prosthetic joint infection\|joint prosthesis]]
	**Cierny-Mader classification based on area of bone involvement		**Cierny-Mader classification based on area of bone involvement<ref>

			Cierny G, Mader JT, Penninck JJ. A clinical staging system for adult osteomyelitis. Clinical Orthopaedics and Related Research. 2003;(414):7–24. doi: [https://doi.org/10.1097/01.blo.0000088564.81746.62 10.1097/01.blo.0000088564.81746.62]</ref>
	***Type I: medullary		***Type I: medullary
	***Type II: superficial		***Type II: superficial

Aidan: /* OVIVA Trial */

2022-08-17T16:38:06Z

OVIVA Trial

← Older revision		Revision as of 16:38, 17 August 2022
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	\|}		\|}

	=== OVIVA Trial ===		=== [https://www.wikijournalclub.org/wiki/OVIVA OVIVA Trial] ===

	* Oral therapy non-inferior to intravenous therapy for bone and joint infections requiring 6+ weeks of therapy[[CiteRef::li2019or]]		* Oral therapy non-inferior to intravenous therapy for bone and joint infections requiring 6+ weeks of therapy[[CiteRef::li2019or]]

Aidan: adjusted table formatting

2022-08-03T15:13:29Z

adjusted table formatting

← Older revision		Revision as of 15:13, 3 August 2022
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	!Foot and Ankle		!Foot and Ankle
	\|-		\|-
	\| ~~colspan~~="2" \|Gram-positive		\| rowspan="6" \|[[Gram-positive bacteria]]
⚫	\|
	\|
	\|
	\|
	\|
	\|
	\|-
	\| rowspan="6" \|
	\|[[Staphylococcus aureus]]		\|[[Staphylococcus aureus]]
	\|10-40%		\|10-40%
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	\|		\|
	\|-		\|-
	\| ~~colspan~~="2" \|Gram-~~negatives~~		\| rowspan="4" \|[[Gram-negative bacteria]]
			\|Overall
	\|5-10%		\|5-10%
	\|10-40%		\|10-40%
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	\|35-55%		\|35-55%
	\|-		\|-
	\| rowspan="3" \|
	\|[[Pseudomonas]] species		\|[[Pseudomonas]] species
	\|<5%		\|<5%
Line 113:		Line 105:
	\|<5%		\|<5%
	\|-		\|-
	\| colspan="2" \|~~Fungal~~		\| colspan="2" \|Polymicrobial bacteria
		⚫	\|10-25%
		⚫	\|15-30%
		⚫	\|10-20%
		⚫	\|20-30%
		⚫	\|20
		⚫	\|30-80%
		⚫	\|-
		⚫	\| colspan="2" \|[[Fungi]]
	\|<5%		\|<5%
	\|<5%		\|<5%
Line 120:		Line 120:
	\|<5%		\|<5%
	\|<5%		\|<5%
	\|-
⚫	\| colspan="2" \|~~Polymicrobial~~
⚫	\|10-25%
⚫	\|15-30%
⚫	\|10-20%
⚫	\|20-30%
⚫	\|20
⚫	\|30-80%
	\|}		\|}

Aidan at 16:34, 2 August 2022

2022-08-02T16:34:29Z

← Older revision		Revision as of 16:34, 2 August 2022
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	* Oral therapy non-inferior to intravenous therapy for bone and joint infections requiring 6+ weeks of therapy[[CiteRef::li2019or]]		* Oral therapy non-inferior to intravenous therapy for bone and joint infections requiring 6+ weeks of therapy[[CiteRef::li2019or]]
			* Patients were randomized after at least 7 days of appropriate IV antibiotics
	* Oral regimens included [[fluoroquinolones]] (41%), combination with [[ciprofloxacin]]/[[clindamycin]] or [[ciprofloxacin]]/[[doxycycline]] (14%), [[Beta lactam antibiotics\|beta lactams]] (15%), [[macrolides]] or [[lincosamides]] (11%), [[tetracyclines]] (9%), and other antibiotics (9%)		* Oral regimens included [[fluoroquinolones]] (41%), combination with [[ciprofloxacin]]/[[clindamycin]] or [[ciprofloxacin]]/[[doxycycline]] (14%), [[Beta lactam antibiotics\|beta lactams]] (15%), [[macrolides]] or [[lincosamides]] (11%), [[tetracyclines]] (9%), and other antibiotics (9%)

Aidan: /* OVIVA Trial */

2022-02-17T15:44:08Z

OVIVA Trial

← Older revision		Revision as of 15:44, 17 February 2022
Line 277:		Line 277:
	=== OVIVA Trial ===		=== OVIVA Trial ===

	* Oral therapy non-inferior to intravenous therapy for bone and joint infections requiring 6+ weeks of therapy		* Oral therapy non-inferior to intravenous therapy for bone and joint infections requiring 6+ weeks of therapy[[CiteRef::li2019or]]
	* Oral regimens included fluoroquinolones (41%), combination with ~~cipro~~/~~clinda~~ or ~~cipro~~/~~doxy~~ (14%), beta lactams (15%), macrolides or lincosamides (11%), tetracyclines (9%), and other antibiotics (9%)		* Oral regimens included [[fluoroquinolones]] (41%), combination with [[ciprofloxacin]]/[[clindamycin]] or [[ciprofloxacin]]/[[doxycycline]] (14%), [[Beta lactam antibiotics\|beta lactams]] (15%), [[macrolides]] or [[lincosamides]] (11%), [[tetracyclines]] (9%), and other antibiotics (9%)

	[[Category:Bone and joint infections]]		[[Category:Bone and joint infections]]

Aidan: /* Background */

2022-02-17T15:34:16Z

Background

← Older revision		Revision as of 15:34, 17 February 2022
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	== Background ==		== Background ==
	*Classified by		*Classified by:
	**[[Acute osteomyelitis]] (1 to 2 weeks) versus [[chronic osteomyelitis]] (3 to 6 months), though this classification is not necessarily helpful		**[[Acute osteomyelitis]] (1 to 2 weeks) versus [[chronic osteomyelitis]] (3 to 6 months), though this classification is not necessarily helpful
	**Etiology and location, including the [[Osteomyelitis with orthopedic hardware\|presence of orthopedic hardware]] or [[Prosthetic joint infection\|joint prosthesis]]		**Etiology and location, including the [[Osteomyelitis with orthopedic hardware\|presence of orthopedic hardware]] or [[Prosthetic joint infection\|joint prosthesis]]
			**Cierny-Mader classification based on area of bone involvement
			***Type I: medullary
			***Type II: superficial
			***Type III: localized
			***Type IV: diffuse
			**Immune status and frailty of host

	=== Microbiology ===		=== Microbiology ===
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	** Poorer outcomes		** Poorer outcomes
	** Commonly involves [[Staphylococcus aureus]] iwht a mix of other bacteria		** Commonly involves [[Staphylococcus aureus]] iwht a mix of other bacteria

			== Diagnosis ==

			* Bone biopsy for histology and culture is the gold standard
			* However, diagnosis is usually made based on a combination of physical exam, lab tests, and imaging
			** Physical exam findings: fever, constitutional symptoms, sinus tract, joint pain and swelling, cellulitis at the site
			** Blood tests: elevated WBC or CRP, positive blood cultures
			*** Novel tests: alpha-defensin, D-dimer, synolvial IL-6, and synovial CRP
			** [[Imaging in osteomyelitis\|Imaging]]: MRI is the most sensitive; can also use bone scan and labelled WBC scan, or plain film x-ray or CT (if more chronic)

	==Management==		==Management==

Aidan at 15:22, 17 February 2022

2022-02-17T15:22:44Z

← Older revision		Revision as of 15:22, 17 February 2022
Line 1:		Line 1:
	== Background ==		== Background ==
			*Classified by
	*See also:
			**[[Acute osteomyelitis]] (1 to 2 weeks) versus [[chronic osteomyelitis]] (3 to 6 months), though this classification is not necessarily helpful
	**[[Acute osteomyelitis]]
			**Etiology and location, including the [[Osteomyelitis with orthopedic hardware\|presence of orthopedic hardware]] or [[Prosthetic joint infection\|joint prosthesis]]
	**[[Chronic osteomyelitis]]
	**[[Osteomyelitis with orthopedic hardware]]

	=== Microbiology ===		=== Microbiology ===

			* Based on [[CiteRef::masters2022sk]]

	{\| class="wikitable"		{\| class="wikitable"
	! colspan="2" \|Species		! colspan="2" \|Species
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	\|30-80%		\|30-80%
	\|}		\|}

			* Polymicrobial infections are more common in trauma-related OM, PJI, and diabetic foot infections
			** Poorer outcomes
			** Commonly involves [[Staphylococcus aureus]] iwht a mix of other bacteria

	==Management==		==Management==

Aidan at 15:01, 17 February 2022

2022-02-17T15:01:19Z

@@ Line 1: / Line 1: @@
 *See also:
 **[[Acute osteomyelitis]]
 **[[Chronic osteomyelitis]]
 **[[Osteomyelitis with orthopedic hardware]]
 ==Management==