Which among the following is the management of acute osteomyelitis ?
Ans: a (Antibiotics soon after taking blood sample) Maheshwari, ed,(Rev)p. 159Broad spectrum antibiotics after taking blood for culture and sensitivity is the initial management of osteomyelitis.Acute osteomyelitis* Infection of the bone by micro organisms.* Most common site--lower femoral metaphysis > upper tibial metaphysis* Most common organism--Staph aureus.Clinical featuresAcute onset of pain and swelling at the end of the bone.On examination--classical signs of inflammation present.InvestigationEarliest investigation to pick osteomyelitis is Tc 99 bone scan--it shows increased uptake by bone in metaphysis.Earliest sign in x-ray--Periosteal new bone deposition by 7-10 daysTreatmentWithin 48 hoursRest in a splint or by traction.Broad spectrum antibiotics after taking blood for culture and sensitivity.IV fluids and other supportive measures.DOC-cefotaxime + amikacin- X 6 weeks change according to culture and sensitivity reportsAfter 48 hrsSurgical exploration & drainageRest, antibiotics and hydrationComplications1) C/c osteomyelitis--commonest complication2) A/c pyogenic arthritis3) Pathological fracture4) Growth disturbance--shortening .lengthening etc
Antibiotic treatment soon after taking blood sample
Surgical excision of infected bone.
Sequestrectomy
Amputation
Infection of Bones & Joints