Criteria for osteomyelitis – one or more of the following:
(1) culture from bone is positive for micro-organisms
(2) evidence of infected bone seen directly at a surgical operation
(3) evidence of an infection involving bone seen in histopathologic examination of a biopsy taken at surgery or needle biopsy
(4) all of the following:
(4a) 2 or more of the following
(4a1) fever > 38°C
(4a2) localized swelling
(4a3) tenderness
(4a4) heat
(4a5) drainage
(4b) no other recognized cause
(4c) one or more of the following
(4c1) positive antigen test on blood for common pathogenic bacteria
(4c2) micro-organism isolated from blood
(4c3) radiographic evidence of infection involving bone
where:
• Radiographic evidence of infection may include a positive readiolabel scan (gallium, technetium, other), CT scan, MRI or routine X-rays.
• Common pathogenic bacteria are Hemophilus influenzae and Streptococcus pneumoniae..
• Antigen tests done on blood are neither sensitive nor specific.
An infection of the sternum following medial sternotomy for open heart surgery is classified as surgical site infection (SSI) with mediastinitis.
