tailieunhanh - Medical Microbiology made memorable - part 6

Tác nhân gây bệnh của xương và khớp và điều trị viêm xương tủy tụ cầu khuẩn gây bệnh của họ Septic. aureus Streptococcus Enterobacteriaceae Pseudomonas spp. Vi khuẩn yếm khí H. influenzae M. lao Coag-neg tụ cầu N. gonorrhoeae Brucella spp. Borrelia burgdorferi Virus | Pathogens of bone and joints and their treatment Osteomyelitis Pathogen Acute Chronic Septic arthritis Empirical Treatments Staph. aureus Flucloxacillin Streptococci Penicillin Enterobacteriaceae R Pseudanoi iss spp. R Anaerobes R Metronidazole H. influenzae R R Ceftriaxone M. tuberculosis Izoniazid rifampicin pyrazinamide Coag-neg staphylococci Vancomycin N. gonorrhoeae R Penicillin Brucella spp. R R Tetracycline Borrelia burgdorferi R Tetracycline Viruses see Table antigen may be found with some viruses but rarely true infection Fungi Sporothrix schenckii R R Amphotericin B most common less common R rare Specific choice depends on susceptibility data FIG Sources of infection of bone joint and muscle Causes of reactive arthritis Strep. pyogenes Salmonella Shigella Campylobacter Yersinia Borrelia burgdorferi Lyme disease Chlamydia trachomatis Mycoplasma pneumoniae Rubella B19 Hepatitis B virus Ross River virus Alphaviruses Other viruses rarely FIG X-ray showing chronic ostemyelitis of the tibia 65 M E D I C A L MICROBIOLOGY Septicaemia Septicaemia is a clinical term describing signs of infection associated with micro-organisms in the blood stream. The term bacteraemia simply refers to the presence of bacteria in the blood sometimes transiently with or without symptoms. Septicaemia carries a high mortality and must be recognised investigated and treated promptly. The risk factors associated with septicaemia are shown in Table . The incidence of many community-acquired infections has changed little in recent years. In hospital-acquired infections the increasing use of invasive procedures immunosuppressive therapy and broad-spectrum antimicrobials has lead to an increase in the proportion of Gram-positive isolates especially coagulase-negative staphylococci and enterococci. Fig. shows the organisms isolated in a large teaching hospital laboratory. The clinical features often include fever sometimes with rigors tachycardia hypotension confusion