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Sports Medicine Infections

Sports Medicine 

-50% of primary care sports medicine is due to infection

  • Infections & Exercise

    • mild to moderate exercise
      • lower rates of infection
    • Hight Intensity Exercise
      • 70-80% Max Heart Rate or longer duration
        • increased risk of infections
    • symptoms usually seen 3-4 days after inoculation
      • decreased strength, decreased stroke volume, increased fatigue, etc
  • Fever

    • multistep response to infection
    • increased metabolic rate
      • 10% for every 1 degree C
    • increased peripheral vasoconstriction
    • increased glycolysis
    • Decreased ADH —> increase insensible fluid loss
  • Return to Play

    • neck check
    • if limited above the neck, ok to participate
    • if below the neck, they should be sidelined until they approve
      • worry is about myocarditis
        • contributor to sudden cardiac death, cardiomyopathy
        • diagnosis
          • troponin, ekg, etc
  • Antibiotics

    • Cellulitis
      • Erysipelas – Pen G IM 1.2mil, Pen V PO, Erythromycin
      • Strep & MSSA – Keflex
      • MSSA or MRSA – Clindamycin or Bactrim DS
        • MRSA Considerations
          • Look for systemic infection (Temp > 100.5, decreased BP and/or increased HR)
          • prior MRSA
          • Lack of response to antibiotics
    • Abscess
      • if > 2cm, need antibiotic coverage
      • typically MRSA etiology
        • Bactrim DS or Clindamycin for 7-14 days
        • warm compresses, butadiene soaks
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