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Original Contributions |

Diagnostic Value of Sinus-tract Cultures in Chronic Osteomyelitis

Philip A. Mackowiak, MD; Stephen R. Jones, MD; James W. Smith, MD
JAMA. 1978;239(26):2772-2775. doi:10.1001/jama.1978.03280530036018.
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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 of Staphyloccus aureus from sinus tracts correlated with the presence of S aureus in the operative specimen. However, less than half of the sinus-tract cultures obtained from patients with S aureus osteomyelitis contained this organism. Isolation of bacteria other than S aureus from sinus tracts had a low likelihood of predicting the pathogen isolated from bone.

A presumptive diagnosis of S aureus osteomyelitis is justified if S aureus is isolated from an associated sinus tract. A bacteriologic diagnosis of chronic osteomyelitis based on isolation of common pathogens other than S aureus from sinus tracts must be verified by an appropriate operative culture.

(JAMA 239:2772-2775, 1978)

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