Patient Encounter Part 2

The medical resident suspected osteomyelitis and ordered plain film radiographs. He also swabbed the open wound and sent the swab to the microbiology laboratory for culture and sensitivity. The following result was reported:

Radiograph: Lytic changes consistent with bone destruction

How would you classify the infection in this patient?

How should the results of the wound swab culture be utilized to target the patient's antimicrobial therapy?

• Bone biopsy can provide definitive diagnosis: Samples should be submitted for culture and histology (rarely performed due to invasive nature)

• Blood cultures may be positive in patients with hematogenous osteomyelitis

• Superficial swabs should have a limited role in directing therapy as they may represent colonization rather than infecting organism(s)

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