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kgray007 kgray007
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7 years ago
A 12-year-old girl came to the emergency department complaining of severe pain in her right elbow.  She had fallen from a tree about 2 weeks before and had deeply lacerated her elbow.  She had not had any medical care for the laceration.  Her mother tried to keep it clean by washing with soap and water; she had also applied a triple-antibiotic ointment at least once a day.  Despite this there was some pus present in the wound.  There also was significant pain and swelling of the elbow.  The young lady also had a temperature of 1010 F. A CBC blood test showed a significant increase in the number of white blood cells.   An x-ray of her elbow showed some bone necrosis.  There is also some reactive bone tissue present. 

Name at least three different tissues that might have become infected.  What two different bacteria cause most of these kinds of infections?  Which of these tissues, if infected, is the most difficult to treat?  Why?  What different types of therapy are now necessary?
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7 years ago
From the given case study:

She has a lacerated elbow with bone necrosis and several bacterial infections with damaged tissue and increased white blood cells. The increased temperature and WBC count showing that her immune system is trying to neutralize the pathogens. Here, the she is suffering from a condition called Osteomyelitis.

a)

The three different tissues that might have become infected are as follows:

Here, the damaged area is elbow (a joint), so at the joint of articulation of bones, the bone surface is covered by “articular cartilage” but not osseous tissue. The presence of articular cartilage helps to reduce the friction, allows flexible movement of joints and also absorbs shock. Therefore, articular cartilage is one of the damaged tissues.

Osseous tissue is the tissue of bones, and it contains extracellular matrix, in which cells are embedded. Due to bone necrosis, osseous tissue is one of the damaged tissues. The outer skin surface is another damaged tissue.

b)

Two different bacteria causes most of these kinds of infections are as follows:

Streptococcus pneumonia
Staphylococcus aureus
Coagulase-negative staphylococci
Enterobacteriaceae species
Pseudomonas aeruginosa
Propionibacterium species
c)

The infection of bone osseous tissue due to necrosis is more difficult to treat. This is because is a complex tissue and its remodeling is a difficult process depends on several growth factors, like calcium and magnesium, etc.

d)

The therapy necessary for bone laceration and necrosis is as follows:

Medication, which contains Nonsteroidal anti-inflammatory drugs (NSAIDs), Range-of-motion exercises, reduced weight bearing and Electrical stimulation, etc.
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