Joint Infections and Osteomyelitis – VASP¶
Evaluation¶
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Blood cultures prior to antibiotics
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MRI is the most sensitive and specific imaging modality for osteomyelitis.
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Ortho consult for joint fluid aspirate or bone bx; send for culture and send fluid for cell count/differential.
Management¶
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Hold antibiotics until culture obtained, if patient is clinically stable
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Osteomyelitis is a 6-week treatment course, can consider early transition (at 2-3 weeks) to oral if good bioavailability and susceptibility.
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For prosthetic joint infection, procedure/retention of hardware determines duration
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First line empiric: Vancomycin + ciprofloxacin 750mg BID
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Antimicrobial therapy will ultimately be guided by culture data, ID consult recommended for joint infection treatment due to need for prolonged antibiotic therapy