The Yersinia genus got its name from Alexandre Yersin, who discovered it, and enterocolitica refers to intestine and colon, so Yersinia enterocolitica causes a SKETCHY MICRO. The most common causes of osteomyelitis in children >5 to 16 years are Staphylococcus aureus and streptococci(Yagupsky et al., 1992).Yersinia enterocolitica is a Gram-negative bacillus that belongs to a family of bacteria called the Enterobacteriaceae. 7 7.1 Bartonella henselae 4 7.2 Bruxella 5 7.3 Francisella tularensis 4 7.4 Pasteurella multocida 4 8.1 Mycobacterium tuberculosis 17 8.2 Mycobacterium leprae 9 9.1 Borrelia burgdorferi 8 9.2. Learn faster with spaced repetition.Guideline for the management of osteomyelitis in children and infants (Chometon et al., 2007 Rasmont et al., 2008 Yagupsky et al., 1992).Sketchy Micro.pdf - SKETCHY MICRO BACTERIA 47 videos 5 hr 36 min Bacteria Gram Positive Cocci 1.1 Staph aureus 1.2 Staph epidermidis S saprophyticus. 1.3 - Streptococcus pyogenes (group A strep) 15 1.4 - Streptococcus agalactiae (group B strep) 5 1.5 - Streptococcus pneumoniae & viridans 9 1.6 - Enterococcus faecium & faecalis 4 Chapter 2 - Gram Positive Bacilli 2.1 - Bacillus anthracis & cereus Study Sketchy Micro: Chlamydia flashcards from Billy Tran's class online, or in Brainscape's iPhone or Android app. Bacteria 5.6 Chapter 1 - Gram Positive Cocci 1.1 - Staphylococcus aureus 11 1.2 - Staphylococcus epidermidis & saprophyticus 7.
Pyogenes (GAS) 'Pie Genies' Bakery' 14 x 1.4 Strep. Saprophyticus 'Beauty and the Plumber' 7 x 1.3 Strep. Aureus 'Golden Staff of Moses' 11 x 1.2 Staph.
Since Bartonella henselae is not culturable using routine microbiological techniques, PCR on bone biopsy is required to make a diagnosis. Salmonella species should be considered in children with haemaglobinopathies.Pseudomonas aeruginosa should be considered when puncture wounds to the sole of the foot are the cause of infection.Osteomyelitis is a very rare manifestation of cat-scratch disease (de Kort et al., 2006). Neisseria meningitidis, Haemophilus influenzae, Enterobacteriacaea , and other streptococci are uncommon causes of osteomyelitis (Chometon et al., 2007). B 7.1 Bartonella henselae 'Bart the Leopard' B 7.2 Brucella 'Bruce Farms' B 7.3 Francisella tularensis 'Francis the. Sketchy Micro Table of ContentsMicro.
Stepping on a rusty nail etc.Examination shows swelling and bony tenderness to palpation especially in subcutaneous bones. Any relevant history of recent trauma should be elicited e.g. It is important to ask about: penicillin allergies, Haemophilus influenzae vaccination status and information on previous MRSA carriage/infection because these will influence empirical therapy. Older children will provide an account of increasing localized pain and demonstrate a limp. In infants the history is necessarily sketchy but systemic features as above and “pseudoparalysis” of the affected limb draws the parents’ attention.
Recommendation: Bone biopsies should be collected using aseptic technique and placed in sterile universal containers, where possible a portion of sample or fluid should be directly inoculated into a paediatric blood culture bottle. Recommendation: Bone biopsies should be undertaken in immunocompromised children, when tuberculosis is suspected, when the clinical and radiological diagnosis is uncertain, after treatment failure on first line therapy or if surgery is planned anyway.Bone biopsies are not essential in most children and Blood Cultures are the microbiological investigation of choice, however, in some situations obtaining microbiological confirmation is critical to successful therapy. Baseline white cell count can be helpful, again the WCC may be normal at least initially in acute haematogenous osteomyelitis.
Children usually present within 2 or 3 days of symptom onset but plain Xrays are still helpful as a baseline and may occasionally demonstrate the painful limb is in fact broken or has some other pathological lesion. Imaging Recommendation: plain x-rays of the affected bone should be undertaken in all cases of suspected osteomyelitis.Bone lysis and periosteal elevation are the hallmarks of acute haematogenous osteomyelitis but are usually absent during the initial 10 days or so of the evolution of the disease. Bartonella henselae is not culturable using routine microbiological techniques, PCR on bone biopsy or serology is required to make a diagnosis. Recommendation: Send a blood sample for Bartonella henselae serology in children with osteomyelitis, negative Blood Cultures and a history of cat exposure, such cases should be discussed with microbiology first.
Useful in the initial assessment of the septicaemic child. Urgent surgical drainage is required in both cases. Ultrasound will also demonstrate subperiosteal abscess collection in the late presenting case or where medical treatment is failing.
Pain relief and splintage of adjacent joint in a cast as necessary, according to existing protocols.Surgery has a limited place in the management of acute haematogenous osteomyelitis. Recommendation: Isotope bone scanning is not recommended for routine investigation of osteomyelitis.Isotope bone scanning has a very limited place in modern management but may help in cases where multifocal disease is suspected. General anaesthesia is often required to obtain diagnostic quality MRI in younger children. MRI is especially useful in axial disease of the pelvis and spine.
PVL-positive staphylococci.Surgery may also be required to obtain bone biopsies in immunocompromised children, when tuberculosis is suspected, when the clinical and radiological diagnosis is uncertain, or after treatment failure on first line therapy.DO NOT START ANTIMICROBIALS UNTIL BLOOD CULTURES HAVE BEEN TAKEN. It can also be repeated very easily.Surgery may also be required for particularly virulent pathogens e.g. Ultrasound is an excellent highly specific, easily obtained and well-tolerated examination in such cases. Suspicion is raised by gross swelling, persistent spiking temperatures and failure to improve with medical treatment.
Adjust dose according to plasma concentrations, aim for ‘trough’ levels of 10-20mg/L) PLUSIntravenous Ciprofloxacin (10 mg/kg (max. Recommended therapy for children and infants age 1 month to 16 years with a true immediate-type penicillin allergy:Intravenous Vancomycin (15 mg/kg every 6 hours (do not exceed an initial maximum of 750mg every 6 hours). 2 grams) every 6 hours.),Add Cefotaxime in severe sepsis (50 mg/kg every 6 hours (maximum 12grams per day)) Recommended therapy children age 5 years to 16 years:Intravenous Flucloxacillin (50 mg/kg (max.
Notably, Ceftriaxone failed in two cases of Staphylococcus aureus infection and is not therefore recommended as a routine empirical agent. Ampicillin-subactam has been compared with Ceftriaxone in a randomised study of treatment for skin, joint and bone infections in children (Kulhanjian et al., 1989) Ceftriaxone had a satisfactory clinical and microbiological response in 93% compared to 100% with Ampicillin-subactam. 1.5 grams) every 6–8 hours).There is little high level evidence to direct the choice of appropriate antimicrobial therapy and some data is extrapolated from treatment of adults. Adjust dose according to plasma concentrations, aim for ‘trough’ levels of 10-20mg/L) PLUSIntravenous Cefuroxime (50–60 mg/kg (max.
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