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Bone and Joint Infections, An Issue of Infectious Disease Clinics of North America, E-Book

Bone and Joint Infections, An Issue of Infectious Disease Clinics of North America, E-Book

Steven K. Schmitt

(2017)

Additional Information

Abstract

Dr. Schmitt has put together a comprehensive issue devoted to bone and joint infections. Top experts have created state-of-the-art clinical reviews devoted to the following topics: Native septic arthritis; Reactive arthritis; Prevention of infection in orthopedic prosthetic surgery; Infections of the spine; Radiologic approach to musculoskeletal infections; Infections associated with open fractures; Fungal musculoskeletal infections; Mycobacterial musculoskeletal infections; Diagnosis of prosthetic joint infections-cultures, biomarkers, and criteria; Management of Prosthetic Joint Infections; Osteomyelitis In adults; and Osteomyelitis in children. Readers will come away with clinical information that can be immediately applied to caring for patients recovering from orthopedic surgeries.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Bone and Joint Infections i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
AUTHORS iii
Contents v
Preface: Musculoskeletal Infections: Meeting the Challenge v
Septic Arthritis of Native Joints v
Diagnosis of Prosthetic Joint Infection: Cultures, Biomarker and Criteria v
Management of Prosthetic Joint Infection v
Prevention of Infection in Orthopedic Prosthetic Surgery v
Reactive Arthritis vi
Infections of the Spine vi
Radiologic Approach to Musculoskeletal Infections vi
Osteomyelitis vi
Prevention of Infection in Open Fractures vii
Fungal Musculoskeletal Infections vii
Mycobacterial Musculoskeletal Infections vii
INFECTIOUS DISEASE CLINICS\rOF NORTH AMERICA\r viii
FORTHCOMING ISSUES viii
September 2017 viii
December 2017 viii
March 2018 viii
RECENT ISSUES viii
March 2017 viii
December 2016 viii
September 2016 viii
Preface:\rMusculoskeletal Infections: Meeting the Challenge ix
Septic Arthritis of Native Joints 203
Key points 203
PATHOGENESIS 203
RISK FACTORS 204
CLINICAL PRESENTATION 205
JOINT DISTRIBUTION 205
SEPTIC ARTHRITIS OF CARTILAGINOUS JOINTS 205
BACTERIOLOGY 206
Staphylococcus aureus 206
β-hemolytic Streptococci 206
Pneumococcus 207
Gonococcal Arthritis 207
Enteric Gram-Negative Rods 208
Meningococcal Arthritis 208
SEPTIC ARTHRITIS IN SPECIFIC POPULATIONS OR AFTER UNUSUAL EXPOSURES 208
Coagulase-Negative Staphylococci and Postarthroscopic Septic Arthritis 208
Mycobacterium Tuberculosis 209
Brucellosis 209
Foreign Body Synovitis and Plant Thorn Injuries 209
Human and Animal Bites 209
Whipple Disease 209
Mycoplasmas and Ureaplasmas 210
Intravenous Drug Users 210
Children 210
Prosthetic Joints 211
DIAGNOSIS: PROBLEMS AND PITFALLS 211
ANTIBIOTIC THERAPY 212
JOINT DRAINAGE 213
REFERENCES 214
Diagnosis of Prosthetic Joint Infection 219
Key points 219
INTRODUCTION 219
CLINICAL PRESENTATION 220
PREOPERATIVE EVALUATION 222
White Blood Cell Count and Serologic Tests 223
Synovial Fluid Cell Count and Culture 223
INTRAOPERATIVE EVALUATION 224
Periprosthetic Purulence 224
Histopathology 224
Periprosthetic Tissue Cultures 225
Sonicate Cultures 225
Culture-Negative Prosthetic Joint Infections 226
ADVANCEMENTS IN PROSTHETIC JOINT INFECTION DIAGNOSTICS: NOVEL TESTS 226
Molecular Tests 226
Synovial Fluid Leukocyte Esterase Strip Test 227
Serum Interleukin-6 227
Synovial Fluid Biomarkers 227
Alpha-defensin (α-defensin 1–3) 228
Synovial interleukin-6 228
Synovial C-reactive protein 228
Shoulder and Elbow Arthroplasty Infections 228
Shoulder arthroplasty infection 229
Elbow arthroplasty infection 229
SUMMARY 229
REFERENCES 229
Management of Prosthetic Joint Infection 237
Key points 237
INTRODUCTION 237
GENERAL PRINCIPLES AND TREATMENT SUCCESS 237
SELECTION OF A MEDICAL/SURGICAL STRATEGY 238
TWO-STAGE ARTHROPLASTY EXCHANGE 241
ONE-STAGE ARTHROPLASTY EXCHANGE 244
DÉBRIDEMENT WITH IMPLANT RETENTION 244
RESECTION WITHOUT REIMPLANTATION AND ARTHRODESIS 245
AMPUTATION 246
ANTIMICROBIAL THERAPY IN SPECIFIC SITUATIONS 246
Staphylococcal Infection Treated with Débridement, Antibiotics, and Implant Retention 246
Culture-Negative Prosthetic Joint Infection 247
Fungal Prosthetic Joint Infection 247
Nonsurgical Prosthetic Joint Infection Management 247
SUMMARY 248
REFERENCES 248
Prevention of Infection in Orthopedic Prosthetic Surgery 253
Key points 253
INTRODUCTION 253
Risk Factors 254
PREOPERATIVE FACTORS 254
Obesity and Malnutrition 254
Perioperative Hyperglycemia and Diabetes Control 255
Smoking 255
Anemia 255
Rheumatoid Arthritis and Immunosuppressive Medications 255
Staphylococcus aureus Screening and Decolonization 256
INTRAOPERATIVE FACTORS 256
Perioperative Antimicrobial Prophylaxis 256
Antibiotic-Impregnated Bone Cement and Antibiotic-Laden Implants 257
Skin Preparation and Draping 257
Operating Room Traffic and Laminar Flow 258
POSTOPERATIVE FACTORS 258
Infection at Distant Sites and Preprocedure Prophylaxis 258
Hematoma Formation and Wound Drainage 258
SUMMARY 258
REFERENCES 258
Reactive Arthritis 265
Key points 265
INTRODUCTION 265
Clinical Criteria 265
MICROBIOLOGY 266
EPIDEMIOLOGY 266
PATHOGENESIS 267
CLINICAL PRESENTATION 268
Primary Infection 268
Musculoskeletal Manifestations 268
Extraarticular Manifestations 269
DIAGNOSIS 269
History and Physical Examination 269
Confirmation of Triggering Infection 269
Testing for HLA-B27 270
Acute Phase Reactants 270
Synovial Fluid Analysis 270
Imaging Findings 271
DIFFERENTIAL DIAGNOSIS 271
MANAGEMENT 272
Chronic Reactive Arthritis 273
PROGNOSIS 274
REFERENCES 274
Infections of the Spine 279
Key points 279
INTRODUCTION 279
SPINE INFECTIONS 281
PYOGENIC FACET JOINT INFECTIONS 286
SPONDYLODISCITIS AND PSOAS MUSCLE ABSCESS 289
REFERENCES 293
Radiologic Approach to Musculoskeletal Infections 299
Key points 299
INTRODUCTION 299
CONVENTIONAL RADIOGRAPHS 300
COMPUTED TOMOGRAPHY 300
ULTRASOUND SCAN 300
RADIONUCLIDE IMAGING 300
THREE-PHASE BONE SCINTIGRAPHY 300
GALLIUM SCINTIGRAPHY 301
WHITE BLOOD CELL IMAGING 301
FLUORINE-18-FLUORODEOXYGLUCOSE–PET 301
MRI 301
SOFT TISSUE INFECTIONS 302
Cellulitis 302
Necrotizing Fasciitis 302
Pyomyositis/Abscess 303
SEPTIC ARTHRITIS, BURSITIS, AND TENOSYNOVITIS 305
Septic Arthritis 305
Septic Bursitis and Tenosynovitis 306
PERIPROSTHETIC JOINT INFECTIONS 308
OSTEOMYELITIS 311
Acute Osteomyelitis 311
Chronic Osteomyelitis 314
SPINE INFECTIONS 314
Spondylodiscitis 314
SEPTIC FACET JOINT 318
REFERENCES 321
Osteomyelitis 325
Key points 325
INTRODUCTION AND HISTORY 325
EPIDEMIOLOGY AND CLASSIFICATION 326
PATHOPHYSIOLOGY 326
MICROBIOLOGY 327
CLINICAL PRESENTATION 328
DIAGNOSIS 329
MANAGEMENT 329
KEY CLINICAL PRESENTATIONS 331
Vertebral Osteomyelitis 331
Acute Hematogenous Osteomyelitis in Children 331
Lower Extremity Osteomyelitis in Patients with Diabetes Mellitus 332
Osteomyelitis After Trauma 333
Osteomyelitis in Sickle Cell Disease 334
Osteomyelitis and Injection Drug Use 334
Osteomyelitis and Hemodialysis 334
Infections of the Bony Pelvis 334
REFERENCES 335
Prevention of Infection in Open Fractures 339
Key points 339
INTRODUCTION 339
EVALUATION AND CLASSIFICATION 340
Evaluation of Patient and Extremity 340
Classification of Open Fractures 340
ANTIBIOTIC ADMINISTRATION 341
Role of Antibiotics in Reducing Infection 341
Timing of Antibiotics 341
Choice of Antibiotics 342
The Role of Wound Cultures 343
Duration of Systemic Antibiotic Therapy 344
Local Antibiotic Therapy 344
DEBRIDEMENT AND IRRIGATION 345
Debridement 345
Timing of Debridement 345
Irrigation 346
WOUND MANAGEMENT 346
Wound Closure 346
Soft Tissue Reconstruction 347
FRACTURE FIXATION 348
SUMMARY 348
REFERENCES 349
Fungal Musculoskeletal Infections 353
Key points 353
INTRODUCTION 353
PATHOGENESIS AND PRESENTATION 353
TREATMENT 354
CANDIDA 355
Candida Osteomyelitis 355
Candida Septic Arthritis 357
ASPERGILLUS 357
Aspergillus Osteomyelitis 357
Aspergillus Septic Arthritis 357
NON-ASPERGILLUS FILAMENTOUS FUNGI 358
CRYPTOCOCCUS 358
THE ENDEMIC DIMORPHIC FUNGI 359
PROSTHETIC JOINT INFECTIONS AND OTHER ORTHOPEDIC HARDWARE INFECTIONS 361
SPECIAL POPULATIONS 361
Chronic Granulomatous Disease 361
Illicit Intravenous Drug Use 362
Neonates 362
ANTIFUNGAL PHARMACOLOGY AND OSTEOARTICULAR INFECTIONS 362
SUMMARY 363
REFERENCES 363
Mycobacterial Musculoskeletal Infections 369
Key points 369
INTRODUCTION 369
PATHOGENESIS AND HOST RISK FACTORS 370
RISK FACTORS FOR MUSCULOSKELETAL INVOLVEMENT 370
INCIDENCE OF MUSCULOSKELETAL MYCOBACTERIAL INFECTION 371
CLINICAL MANIFESTATIONS 372
Tuberculosis 372
Nontuberculous Mycobacteria 373
DIAGNOSIS 373
THERAPY FOR MYCOBACTERIAL MUSCULOSKELETAL INFECTIONS 375
General Approaches 375
Mycobacterium tuberculosis 375
Nontuberculous Mycobacteria 378
SUMMARY 379
REFERENCES 379
Index 383