Recent lessons for the management of bone and joint infections

Sheldon L. Kaplan

Research output: Contribution to journalArticle

37 Scopus citations

Abstract

The epidemiology and clinical manifestations of osteoarticular infections are changing primarily as a result of the emergence of community-acquired methicillin-resistant Staphylococcus aureus infections. Multifocal disease, venous thrombosis and pathologic fractures are manifestations of CA-MRSA osteomyelitis. MRI is the diagnostic imaging modality of choice for musculoskeletal infections. Nafcillin/oxacillin or cefazolin remains the antibiotic of choice for treating infections caused by MSSA. A β-lactam antibiotic is recommended for Kingella kingae. Vancomycin and clindamycin are the first line agents for treating osteomyelitis caused by CA-MRSA. A short course of parenteral antibiotics followed by appropriate oral antibiotics is equivalent to total course of parenteral antibiotics for most patients and avoids the risks associated with PICCs. Surgical drainage of subperiosteal abscesses and surrounding pyomyositis is common with S. aureus clones currently circulating. Collaboration with hematologists for managing patients with venous thromboses is recommended.

Original languageEnglish (US)
Pages (from-to)S51-S56
JournalJournal of Infection
Volume68
Issue numberSUPPL1
DOIs
StatePublished - Jan 2014

Keywords

  • Osteomyelitis
  • Septic arthritis
  • Staphylococcus aureus

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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