Long Bone Osteomyelitis Case Studies

Proper collection of blood cultures are necessary and the most direct method of determining whether or not a patient is septic. The purpose of obtaining blood cultures is to identify and isolate the bacteria that are causing an illness and then determine the best course of treatment based on the sensitivity of the bacteria to particular antibiotics. One of the most frustrating problems plaguing hospitals is the increased rate at which blood culture results are being returned as contaminated specimens. These results can lead to a significant increase in cost to the hospital and patient as well as an increased length in hospital

Gold standard procedures should be implemented with the aim of providing timely and accurate results. (Schentag) The culture result should be accompanied by its clinical significance, selective reporting of susceptibility testing results in accordance with hospital antimicrobial therapy guidelines and suggested management. (Schentag) This encourages appropriate prescribing and minimises unnecessary use of antimicrobials. The clinical microbiology team should also provide reports to AMS regarding resistant organisms.

Our tracer patient was a 67 year old female who presented with a fever and drainage five weeks after an open hysterectomy. She was admitted for a suspected postoperative infection,. She underwent another surgery to treat the abscess that formed from the initial surgery and had a central line inserted for long-term antibiotics. She is scheduled to

Osteopetrosis is a rare, genetic disease that causes extremely dense and brittle bones. This is because individuals affected with osteopetrosis do not have normal osteoclasts, which bones need to work correctly. Healthy bones require properly functioning osteoblasts and osteoclasts. Osteoblasts are responsible for making new bones and osteoclasts are bone cells that are responsible for bone resorption, which is the breaking down of bones and providing space for new bone marrow to grow. An individual with osteopetrosis has osteoclasts that do not function properly, therefore their bones are not healthy (Stocks, Wang, Thompson, Stocks, & Horwitz, 1998).

The first step to identifying the unknown bacteria residing on the blood agar plate sent in from Khokana was to do a Gram stain on it. This is an important first step because it dictates further testing that will be necessary to arrive at a final conclusive result. Viewing the fixed and stained slide under the microscope revealed round chains of bacteria in a purple color signaling Gram-positive streptococci. A catalase test was performed with no bubbling present indicating a negative result. This further confirmed the shape and arrangement seen under microscopy. With this mind, the coagulase test was not done, as it would be of no use since that specifies for staphylococcus, specifically for Staphylococcus aureus. For streptococcus, an examination of hemolysis was necessary at this point. Shifting attention back to the original blood agar plate, gamma hemolysis was noted, thus narrowing the field down to two choices left. The unknown bacteria was either Streptococcus bovis or Entercoccus faecalis. This also means the Optochin and Bacitracin sensitivity tests would not be needed as those pinpoint alpha- and

This cancer is a bone cancer that attack the bones, especially large bones. This cancer is named osteogenic sarcoma(Osteosarcoma) for medical term (“Osteosarcoma”, n.d.). Osteosarcoma mostly affects people under 25 years old, and it can affect old people but it is really rare(“Osteosarcoma: An Introduction.”, 2012). When this cancer attacks, it grows bones, and any type of bone (“Bone cancer”,2013). This cancer is an ancient disease that we started to recognize in 1805. Most of the symptoms are on the bones (“Bone cancer”,2013). It also is not contagious so its not passed from person to person like other diseases.

Osteomyelitis, the infection of bone, would cause swelling in the foot, limiting the movement in her foot. It also

The gram stain test was able to identify the bacterium as a gram-positive organism, and the morphology distinguished it as a strain of streptococcus, and these finds helped direct the other tests. Hemolytic tests are very useful in differentiating specific species of a certain family of bacteria. The hemolytic test showed the bacterium to be of alpha clearing, which meant it only partially lysed the red blood cells and left a greenish tint. This identified the bacterium as either strep pneumoniae or faecalis. The bacitracin test, which tests whether the bacterium is susceptible to the antibiotics in the disk, posted a positive

1. A healthy high school athlete is diagnosed with fever and cellulitis of the right knee. The infection is resistant to oral antibiotics. He then develops osteomyelitis of the right knee. If untreated, the infection could result in

The patient is a 72 year old female. She has been experiencing progressively worse pain and stiffness in her joints. She is reports that she is having decreased range of motion, redness, and swelling in her joints. She is reports symptoms occur in the same joints on both sides of her body. She is also reporting the symptoms are worse when she first wakes up in the morning.

There are a few antibiotics that are affected in this case which include cephalosporin and also include penicillin (Munoz-Price & Jacoby, 2015). There are a few different ESBL’s which include TEM, SHV, CTX-M, OXA, and many others (Munoz-Price & Jacoby, 2015). All of the strains will be treated slightly differently due to the different chemical makeup (Munoz-Price & Jacoby, 2015). In order to determine the presence of ESBLs, lab tests can be used such as disk diffusion and pyrosequencing ((Munoz-Price & Jacoby, 2015). Every patient has a different level of risk for becoming contaminated with ESBLs such as the differing lengths in hospital stay, as well as whether the patient has a PICC line (Munoz-Price & Jacoby, 2015). Another risk factor for the patient may be that they were previously in a nursing home (Munoz-Price & Jacoby, 2015). With the patient being elderly, the chances that they may have been in a nursing home are

Osteomyelitis is a broad and debilitating disease typically triggered by a variety of conditions. Osteomyelitis starts off as inflammation seen within bone and bone marrow that can quickly progress into a large, subclassified infection. The length of time the infection has been present in the body and whether or not there is a pus formation or increased density among the infected bone is commonly used to classify severity. Pyrogenic bacteria or mycobacteria systematically attack the route and anatomic location of the infection evolving acute conditions into chronic ones. “Staphylococcus Aureus is a gram-positive, round shaped, non-mobile cocci typically found in clusters inside these wounds. Staphylococcus Aureus is one of the most common causes of infections after injury or surgery and affects nearly 500,000 patients in hospitals each year. Staphylococcus Aureus belongs to the family Staphylcoccaceae and survives by affecting all known mammalian species including humans” (www.news-medical.net). Osteomyelitis can start in one area of the body while spreading through the blood stream into other bone regions. Typical treatment options for Osteomyelitis includes antibiotics, removal of

Osteomalacia may be asymptomatic and present radiologically as osteopenia. It can also produce characteristic symptoms, independently of the underlying cause, including diffuse bone and joint pain, muscle weakness, and difficulty walking .

In case of clearly established bacterial infection to otorhinolaryngological evaluation or in the event of persistence of fever with painful symptomatology after the first 72 hours the antibiotic is necessary. Generally they use broad-spectrum antibiotics properly administered daily dose and duration. In the event of repeated infections, and in close suspicion of insufficient efficacy, sensitivity testing provides information useful sull'antibiotico to which the beat is sensitive or sull'antibiotico more effective for therapeutic treatment.

They have diminished inflammatory response even when extreme soft tissue and bone infection are present. Identification of foot infections in the patient with diabetes mellitus requires vigilance because the signs of infection may not be present ( Baranoski and Ayello, 2003,p.327). The most common bacteria found in non-limb threatening infection are Staphylococcus and Streptococcus. These infections should be treated with oral antibiotics. If the limb is threatened with the infection, parenteral antibiotics and surgical debridement of necrotic tissue needs to be executed. Most limb threatening infections are polymicrobial. Staphylococcus aureus, group B atreptococci, Enterococcus, and facultative Gram-negative bacilli are the major pathogens involved in these types of