Vertebral osteomyelitis - Revision history

Aidan at 23:17, 12 March 2022

2022-03-12T23:17:04Z

← Older revision		Revision as of 23:17, 12 March 2022
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	*[[Staphylococcus aureus]]		*[[Staphylococcus aureus]]
	*Other [[Gram-positive cocci]], including [[viridans group streptococci]], [[Streptococcus bovis]], [[enterococci]], [[Streptococcus agalactiae]], group C and G [[streptococci]]		*Other [[Gram-positive cocci]], including [[viridans group streptococci]], [[Streptococcus bovis]], [[enterococci]], [[Streptococcus agalactiae]], group C and G [[streptococci]]
	*Less commonly, [[coagulase-negative staphylococci]], [[Gram-negative bacilli]], including [[Pseudomonas aeruginosa]], and [[Candida ~~species~~]], especially in patients with indwelling lines or injection drug use		*Less commonly, [[coagulase-negative staphylococci]], [[Gram-negative bacilli]], including [[Pseudomonas aeruginosa]], and [[Candida]], especially in patients with indwelling lines or injection drug use
	*[[Tuberculosis]]		*[[Tuberculosis]]
	*[[Brucella melitensis\|Brucella]], in patients from endemic countries, can be as high as 25% of cases		*[[Brucella melitensis\|Brucella]], in patients from endemic countries, can be as high as 25% of cases

Aidan: /* With Orthopedic Hardware */

2021-12-15T14:07:08Z

With Orthopedic Hardware

← Older revision		Revision as of 14:07, 15 December 2021
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	* Often treated with retention of hardware, especially in early-onset disease[[CiteRef::atesok2020fa]]		* Often treated with retention of hardware, especially in early-onset disease[[CiteRef::atesok2020fa]]
	* Early onset (<4 to 6 weeks post-op)		* Early onset (<4 to 6 weeks post-op)
	** I&D with retention of hardware and bone graft material, with primary closure ~~over~~ a drain if feasible		** I&D with retention of hardware and bone graft material, with primary closure instead of a drain, if feasible
	* Late onset (more than 4 to 6 weeks post-op)		* Late onset (more than 4 to 6 weeks post-op)
	** Fusion achieved: incision and drainage with removal of hardware		** Fusion achieved: incision and drainage with removal of hardware

Aidan at 14:02, 15 December 2021

2021-12-15T14:02:32Z

← Older revision		Revision as of 14:02, 15 December 2021
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	==Management==		==Management==

	*IV or highly bioavailable oral (metronidazole, fluoroquinolones, linezolid, TMP-SMX, clindamycin, and doxycycline/rifampin)		*IV or highly bioavailable oral ([[metronidazole]], [[fluoroquinolones]], [[linezolid]], [[TMP-SMX]], [[clindamycin]], and [[doxycycline]]/[[rifampin]])
	**Can double-cover ''Enterococcus'' with an aminoglycoside for 4 to 6 weeks		**Can double-cover ''[[Enterococcus]]'' with an [[Aminoglycosides\|aminoglycoside]] for 4 to 6 weeks
	*Duration: 6 weeks for most, but 3 months for ''Brucella''		*Duration: 6 weeks for most, but 3 months for ''[[Brucella]]''
	*

	===''Brucella''===		===''Brucella''===

			*Combination of [[doxycycline]] and [[rifampin]]
	*Doxycycline/rifampin
	*Duration: 3 months		*Duration: 3 months

Aidan: /* Management */

2021-04-28T13:19:03Z

Management

← Older revision		Revision as of 13:19, 28 April 2021
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	== Background ==		==Background==

	===Microbiology===		===Microbiology===
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	*Doxycycline/rifampin		*Doxycycline/rifampin
	*Duration: 3 months		*Duration: 3 months

			=== With Orthopedic Hardware ===

			* Often treated with retention of hardware, especially in early-onset disease[[CiteRef::atesok2020fa]]
			* Early onset (<4 to 6 weeks post-op)
			** I&D with retention of hardware and bone graft material, with primary closure over a drain if feasible
			* Late onset (more than 4 to 6 weeks post-op)
			** Fusion achieved: incision and drainage with removal of hardware
			** Fusion not achieved: retention of hardware with suppressive antibiotics until fusion is achieved, then removal of hardware

	==Prognosis==		==Prognosis==

Aidan at 19:09, 13 October 2020

2020-10-13T19:09:21Z

← Older revision		Revision as of 19:09, 13 October 2020
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	== ~~Microbiology~~ ==		== Background ==

			===Microbiology===
⚫	* ''Staphylococcus aureus''
⚫	* ''Brucella'', in patients from endemic countries, can be as high as 25% of cases

		⚫	*[[Staphylococcus aureus]]
⚫	== Management ==
			*Other [[Gram-positive cocci]], including [[viridans group streptococci]], [[Streptococcus bovis]], [[enterococci]], [[Streptococcus agalactiae]], group C and G [[streptococci]]
			*Less commonly, [[coagulase-negative staphylococci]], [[Gram-negative bacilli]], including [[Pseudomonas aeruginosa]], and [[Candida species]], especially in patients with indwelling lines or injection drug use
			*[[Tuberculosis]]
		⚫	*[[Brucella melitensis\|Brucella]], in patients from endemic countries, can be as high as 25% of cases

		⚫	==Management==
⚫	* IV or highly bioavailable oral (metronidazole, fluoroquinolones, linezolid, TMP-SMX, clindamycin, and doxycycline/rifampin)
⚫	** Can double-cover ''Enterococcus'' with an aminoglycoside for 4 to 6 weeks
⚫	* Duration: 6 weeks for most, but 3 months for ''Brucella''
⚫	*

		⚫	*IV or highly bioavailable oral (metronidazole, fluoroquinolones, linezolid, TMP-SMX, clindamycin, and doxycycline/rifampin)
⚫	=== ''Brucella'' ===
		⚫	**Can double-cover ''Enterococcus'' with an aminoglycoside for 4 to 6 weeks
		⚫	*Duration: 6 weeks for most, but 3 months for ''Brucella''
		⚫	*

		⚫	===''Brucella''===
⚫	* Doxycycline/rifampin
⚫	* Duration: 3 months

		⚫	*Doxycycline/rifampin
⚫	== Prognosis ==
		⚫	*Duration: 3 months

		⚫	==Prognosis==
⚫	* Cure rates are 70-90% with 6 weeks of antibiotics, and are ''not'' higher with longer durations (per a single RCT)

⚫	* Poor prognosis is associated with multidisc disease, the presence of concomitant epidural abscess, lack of surgical therapy, infection with ''S. aureus'', old age, or the presence of significant comorbidities
		⚫	*Cure rates are 70-90% with 6 weeks of antibiotics, and are ''not'' higher with longer durations (per a single RCT)
		⚫	*Poor prognosis is associated with multidisc disease, the presence of concomitant epidural abscess, lack of surgical therapy, infection with ''S. aureus'', old age, or the presence of significant comorbidities

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

Aidan at 19:40, 15 August 2019

2019-08-15T19:40:27Z

← Older revision		Revision as of 19:40, 15 August 2019
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	= Microbiology =		== Microbiology ==

	* ''Staphylococcus aureus''		* ''Staphylococcus aureus''
	* ''Brucella'', in patients from endemic countries, can be as high as 25% of cases		* ''Brucella'', in patients from endemic countries, can be as high as 25% of cases

	= Management =		== Management ==

	* IV or highly bioavailable oral (metronidazole, fluoroquinolones, linezolid, TMP-SMX, clindamycin, and doxycycline/rifampin)		* IV or highly bioavailable oral (metronidazole, fluoroquinolones, linezolid, TMP-SMX, clindamycin, and doxycycline/rifampin)
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	*		*

	== ''Brucella'' ==		=== ''Brucella'' ===

	* Doxycycline/rifampin		* Doxycycline/rifampin
	* Duration: 3 months		* Duration: 3 months

	= Prognosis =		== Prognosis ==

	* Cure rates are 70-90% with 6 weeks of antibiotics, and are ''not'' higher with longer durations (per a single RCT)		* Cure rates are 70-90% with 6 weeks of antibiotics, and are ''not'' higher with longer durations (per a single RCT)

Aidan at 17:26, 12 August 2019

2019-08-12T17:26:17Z

← Older revision		Revision as of 17:26, 12 August 2019
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		⚫	= Microbiology =
	= Vertebral osteomyelitis =

⚫	== Microbiology ==

	* ''Staphylococcus aureus''		* ''Staphylococcus aureus''
	* ''Brucella'', in patients from endemic countries, can be as high as 25% of cases		* ''Brucella'', in patients from endemic countries, can be as high as 25% of cases

	== Management ==		= Management =

	* IV or highly bioavailable oral (metronidazole, fluoroquinolones, linezolid, TMP-SMX, clindamycin, and doxycycline/rifampin)		* IV or highly bioavailable oral (metronidazole, fluoroquinolones, linezolid, TMP-SMX, clindamycin, and doxycycline/rifampin)
Line 13:		Line 11:
	*		*

	=== ''Brucella'' ===		== ''Brucella'' ==

	* Doxycycline/rifampin		* Doxycycline/rifampin
	* Duration: 3 months		* Duration: 3 months

	== Prognosis ==		= Prognosis =

	* Cure rates are 70-90% with 6 weeks of antibiotics, and are ''not'' higher with longer durations (per a single RCT)		* Cure rates are 70-90% with 6 weeks of antibiotics, and are ''not'' higher with longer durations (per a single RCT)
	* Poor prognosis is associated with multidisc disease, the presence of concomitant epidural abscess, lack of surgical therapy, infection with ''S. aureus'', old age, or the presence of significant comorbidities		* Poor prognosis is associated with multidisc disease, the presence of concomitant epidural abscess, lack of surgical therapy, infection with ''S. aureus'', old age, or the presence of significant comorbidities

			[[Category:Bone and joint infections]]

Aidan: Aidan moved page Bone and joint Vertebral osteomyelitis to Vertebral osteomyelitis without leaving a redirect

2019-08-12T17:25:52Z

Aidan moved page Bone and joint Vertebral osteomyelitis to Vertebral osteomyelitis without leaving a redirect

← Older revision	Revision as of 17:25, 12 August 2019
(No difference)

Maintenance script: Imported from text file

2019-08-11T18:05:48Z

Imported from text file

New page

= Vertebral osteomyelitis =

== Microbiology ==

* ''Staphylococcus aureus''
* ''Brucella'', in patients from endemic countries, can be as high as 25% of cases

== Management ==

* IV or highly bioavailable oral (metronidazole, fluoroquinolones, linezolid, TMP-SMX, clindamycin, and doxycycline/rifampin)
** Can double-cover ''Enterococcus'' with an aminoglycoside for 4 to 6 weeks
* Duration: 6 weeks for most, but 3 months for ''Brucella''
*

=== ''Brucella'' ===

* Doxycycline/rifampin
* Duration: 3 months

== Prognosis ==

* Cure rates are 70-90% with 6 weeks of antibiotics, and are ''not'' higher with longer durations (per a single RCT)
* Poor prognosis is associated with multidisc disease, the presence of concomitant epidural abscess, lack of surgical therapy, infection with ''S. aureus'', old age, or the presence of significant comorbidities