NATS 1540 Lecture Notes - Lecture 64: Septic Arthritis, Lumbar Puncture, Metaphysis
31 May 2020
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Of cases in kids less than 15 years old. Route of infection: most cases are from contiguous infection, 25% of cases are from hematogenous infection (blood infection), 15-20% of cases from unknown origin. Clinical signs: most cases have a fever (70%), 50% of cases have neurological deficit. Nausea, vomiting, seizures, stiff neck are also symptoms. Diagnosis: imaging scans (ct, mri) with a donut lesion. Antibiotics used are penicillin for streptococci, metronidazole for anaerobes, 3rd generation cephalosporins for enterobacteria, and cloxicillin for s. aureus. Bone is metabolically active-it has collagen and mineral actively remodeled. Children have growing bones, but the elderly have net loss (so they have brittle bones) Bone has blood circulation, but it is limited. It has afferent arterial loops with no phagocytes, and efferent loops with functionally inactive lining cells and turbulent flow. Metaphysis of the bone is where growth occurs (growth plate) but this place needs blood supply and is usually the area getting infected.
