Jean et al studied patients with pyogenic vertebral osteomyelitis and considered reasons for a delay in diagnosis. The authors are from multiple institutions in France.
Patient selection: pyogenic vertebral osteomyelitis (50% Staphylococcus)
The patient typically presents with back pain.
Diagnosis can be a challenge if:
(1) the patient is afebrile and symptoms vague
(2) routine X-rays are not diagnostic
Clues to diagnosis:
(1) serum C-reactive protein (CRP) > 63 mg/L
(2) positive blood culture
MRI of the spine can help identify foci of infection.
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Specialty: Infectious Diseases
