Most common cause of osteomyelitis below 4 years of age?
Correct Answer: H. influenzae
Description: Ans. d (H. influenzae) (Ref, Nelson pediatrics 18th/ 2843; Manual of orthopaedics by Marc, F. Swiontkowski p. 83)# S, aureus is the most common bacterial pathogen, followed by gram-negative rods, group A streptococcus, and H. influenzae (less likely now due to HIB vaccination).# Pseudomonas aeruginosa is most vital cause of osteomyelitis of foot, especially if there is a puncture wound.# Salmonella is the most common cause of osteomyelitis in patients with hemoglobinopathy.ACUTE OSTEOMYELITISOrganisms of the basis of patient age: a. Younger than 1 yearb. 1 to 4 year oldc. Older than 4 yearsd. Adolescenti. Staphylococcus aureusii. Group B streptococcusiii. Escherichia colii. S. aureusii. Haemophilus influenzaei. S.aureusi. S.aureusii. Neisseria gonorrhoeaeCommon organisms causing infections in a particular setting1.Most common clinical associationMicroorganism2.Frequent organism in any type of osteomyelitisS. aureus3.Most Frequent organism in acute osteomyelitis < 4 yrs ageS. aureus & H. influenzae4.Foreign body associated infectionCNS or Propionibacterium5.Common in nasocomial infectionEnterobacteriacea, P. aeruginosa, Candida6.Sickle cell diseaseSalmonella7.HIV infectionBartonella henselae8.Human or animal bitesPasturella multocidaRadiolgical investigations in acute osteomyelitisType of StudyCommentsPlain radiographs# Insensitive, especially in early osteomyelitis.# May show periosteal elevation after 10 days, lytic changes after 2-6 weeks.Three-phase bone scan (99mTc-MDP)# Characteristic finding in osteomyelitis: increased uptake in all three phases of scan.# Highly sensitive (~95%) in acute infection.67Ga-citrate, 111In-labeled WBCs scans# 111In-WBCs more specific than gallium but not always available.# Lack of consensus over role; often supplanted by MRI when the latter is available.MRI# As sensitive as 99mTc-MDP bone scan for acute osteomyelitis (~95%).# High specificity (~87%), with better anatomic detail than nuclear studies.
Category:
Orthopaedics
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now