Diagnostic value of sinus-tract cultures in chronic osteomyelitis

JAMA. 1978 Jun 30;239(26):2772-5. doi: 10.1001/jama.239.26.2772.


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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bacteriological Techniques*
  • Bone and Bones / microbiology
  • Child
  • Child, Preschool
  • Chronic Disease
  • Evaluation Studies as Topic
  • Female
  • Fistula / microbiology
  • Humans
  • Male
  • Middle Aged
  • Osteomyelitis / diagnosis
  • Osteomyelitis / etiology
  • Osteomyelitis / microbiology*
  • Staphylococcal Infections / complications
  • Staphylococcus aureus / isolation & purification