Diagnostic Value of Sinus-tract Cultures in Chronic Osteomyelitis

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Abstract
Sinus-tract cultures were compared with cultures of operative specimens from 40 patients with chronic osteomyelitis. Thirty-five patients (87.5%) had a single pathogen isolated from their operative specimens. Only 44% of the sinus-tract cultures contained the operative pathogen. Isolation ofStaphyloccus aureusfrom sinus tracts correlated with the presence ofS aureusin the operative specimen. However, less than half of the sinus-tract cultures obtained from patients withS aureusosteomyelitis contained this organism. Isolation of bacteria other thanS aureusfrom sinus tracts had a low likelihood of predicting the pathogen isolated from bone. A presumptive diagnosis ofS aureusosteomyelitis is justified ifS aureusis isolated from an associated sinus tract. A bacteriologic diagnosis of chronic osteomyelitis based on isolation of common pathogens other thanS aureusfrom sinus tracts must be verified by an appropriate operative culture. (JAMA239:2772-2775, 1978)

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