[Skip to Content]
[Skip to Content Landing]
Original Contribution
June 30, 1978

Diagnostic Value of Sinus-tract Cultures in Chronic Osteomyelitis

Author Affiliations

From the Medical Service, Veterans Administration Hospital, Dallas (Drs Mackowiak and Smith) and Portland, Ore (Dr Jones), Department of Internal Medicine, University of Texas Health Science Center at Dallas, Southwestern Medical School, Dallas (Drs Mackowiak and Smith), and University of Oregon Health Science Center, Portland (Dr Jones).

JAMA. 1978;239(26):2772-2775. doi:10.1001/jama.1978.03280530036018

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)