Diagnostic value of sinus-tract cultures in chronic osteomyelitis.
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.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001431:Bacteriological Techniques; D001842:Bone and Bones / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005069:Evaluation Studies as Topic; D005260:Female; D005402:Fistula / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000150:complications; D013211:Staphylococcus aureus / Q000302:isolation & purification