Skip to main content

Osteomyelitis — Considerations for Biopsy or Surgical Intervention — Clinical Pathway: Emergency and Inpatient

Osteomyelitis Clinical Pathway — Emergency Department and Inpatient

Considerations for Biopsy or Surgical Intervention

Intervention Indications Tests to Order
Surgery
  • Abscess
  • Necrotic bone requiring debridement
  • Failure to respond to empiric therapy
  • Unclear diagnosis
  • Send Aerobic culture (includes gram stain)
  • Consider anaerobic culture if concern for spread from contiguous infection, ischemia, or trauma
  • Consider fungal culture if concern for penetrating trauma or immunocompromised
Biopsy
Generally done by Interventional Radiology
  • Generally recommended by infectious diseases if unclear diagnosis or concern for uncommon pathogen
  • Send aerobic culture (includes gram stain)
  • Consider anaerobic culture if concern for spread from contiguous infection, ischemia, or trauma
  • Consider fungal culture If concern for penetrating trauma or immunocompromised
  • Anatomic pathology

References

  • UptoDate: Hematogenous osteomyelitis in children: Management
  • UptoDate: Hematogenous osteomyelitis in children: Epidemiology, pathogenesis, and microbiology
  • Anaerobic Osteomyelitis in Children  

 

Jump back to top