Foot the Bill
Common complications of diabetic foot infection.
hospitalization, osteomyelitis, amputation
Type of organism most commonly associated with septic arthritis.
Gram (+) organisms (Staph, Strep, Enterococcus)
The mechanism of bone infection most common in pediatric patients.
Hematogenous inoculation
Criteria for classifying a mild diabetic foot infection.
Local infection (skin/subcutaneous tissue), erythema <2 cm, no systemic infection signs
Signs that a prosthetic joint infection may exist.
Persistent wound drainage from prosthesis (sinus tract formation), acute onset of pain, chronic pain unresolved by joint replacement
Classification of a moderate diabetic foot infection includes these findings.
erythema >2 cm or deeper skin/subcutaneous structure involvement, no systemic infection signs
The joint most commonly infected with monomicrobial septic arthritis.
Knee
The time since duration of onset for chronic osteomyelitis.
>2 weeks
Recommended antibiotic therapy for septic arthritis due to Gram (+) organisms.
Vancomycin, daptomycin, linezolid
The antibiotic class frequently used for oral treatment of prosthetic joint infections after intravenous therapy has been completed.
Fluoroquinolones
The organism that antibiotic therapy is targeted against with mild diabetic foot infection.
Staphylococcus aureus (MSSA or MRSA)
The triad of signs/symptoms with gonococcal septic arthritis.
dermatitis, tenosynovitis, migratory polyarthralgia/polyarthritis
The duration of treatment for septic arthritis.
14-28 days
Preferred antibiotic for treatment of septic joint due to Neisseria gonorrhoeae.
Ceftriaxone
The indication for using rifampin for treatment of a prosthetic joint infection and benefits of its use.
Retention of hardware in infected joint; promotes antibiotic penetration/activity in biofilm on hardware
Two or more signs of SIRS in severe diabetic foot infection.
Temp >38 C (or <36), HR >90 bpm, RR >20 breaths/min, WBC >12 K (or <4 K or 10% bands)
Chronic health conditions that predispose to development of septic arthritis.
Diabetes, rheumatoid arthritis
The minimum duration of therapy for treatment of osteomyelitis.
4-6 weeks
Preferred antibiotic(s) for prosthetic joint infection due to Enterococci.
Ampicillin, (PCN-allergy: Vancomycin)
The duration of time that an infected prosthesis can initially be retained and concurrently treated with antibiotics.
Within first 30 post-operative days
Organism(s) that should be targeted in severe diabetic foot infections
MRSA, Gram (-) aerobes, anaerobes
The timing of prosthetic joint replacement during a one-stage exchange.
During the same surgery to remove the infected hardware.
Age ranges that predispose to development of septic arthritis.
>80 yrs (elderly), infants <2 yrs
Recommended empiric antibiotic therapy when Gram stain of joint aspirate is negative.
Vancomycin + ceftriaxone
1-2%