Microbiology of the Musculoskeletal system

Click to edit Master subtitle style Ziad Elnasser, MD, Ph.D

Introduction
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Bacteria, Viruses, Fungi, Parasites. Through the skin, subcutaneous, bone, penetrating wounds, decubitous ulcers. Hematogenous spread. Specific (Clostridium myonecrosis) Non specific (Myalgias of viral infection) Pyomyositis. S.aureus in > 95%. Others including HIV.

Group A necrotizing myositis

Spontaneous strepotcoccal gangrenous myositis. Necrotizing fascitis. Diagnosis Treatment.

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Clostridial myonecrosis
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Clostridium perfrengens in 95%. Cl. novyi, Cl. septicum, Cl. histolyticum, Cl. fallax. G+ nonmotile rod, strict anaerobe, double zone of hemolysis, lots of CO2 + H2. Many exotoxins A E. toxin. toxin.

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Contaminated traumatic wounds. Pt normal flora, or from soil. Fractures, bullets, war injuries. Food poisoning. Pathogenesis due to toxins. Clinical manifestation. Anaerobic cellulitis, endometritis.

Diagnosis
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Clinical observation. Anaerobic culture. Double zone of hemolysis. GLC

GLC=gas liquid chemotherapy

Treatment and prevention

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Excision of all devitilized tissue, debridment. Hyperbaric O2 treatment. Massive dose of penicillin

Trichinella spiralis