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CT-guided discitis-osteomyelitis biopsies with negative microbiology: how many days should we wait before repeating the biopsy?

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Abstract

Purpose

To determine the number of days to positive CT-guided biopsy sample culture in patients with discitis-osteomyelitis.

Methods

Our study was IRB approved and HIPAA compliant. All CT-guided biopsies performed for acute discitis-osteomyelitis with positive microbiology between 2002 and 2018 were reviewed. Microbiological organism and days to positive biopsy were documented. Mean, median, skew, and standard deviation were calculated. The proportion of positive cultures that become positive after each day has elapsed was also calculated.

Results

There were 96 true positive cultures, with 64 (67%) male and 32 (33%) female, ages 57 ± 18 (range 19–87) years. Overall, including all culture results, the mean number of days to positive culture was 2.9 ± 3.5 days. The median number of days was 2, with a positive skew of 2.9. At days 1, 2, 3, 4, and 5, 48%, 68%, 78%, 85%, and 89%, respectively, of biopsy samples had a positive microbiology culture.

Conclusion

Approximately three-quarters of discitis-osteomyelitis pathogens will be identified by biopsy sample culture by 3 days after CT-guided biopsy. This finding should be considered if planning for a repeat biopsy in the setting of a negative microbiology culture.

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Authors and Affiliations

  1. Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street Yawkey 6E, Boston, MA, 02114, USA

    Kaitlyn J. Yeh, Jad S. Husseini, Robert Hemke & Connie Y. Chang

  2. Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 20114, USA

    Sandra B. Nelson

Authors
  1. Kaitlyn J. Yeh
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  2. Jad S. Husseini
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  3. Robert Hemke
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  4. Sandra B. Nelson
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  5. Connie Y. Chang
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Correspondence to Connie Y. Chang.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was waived for individual participants included in the study. The study was approved by the local Institutional Review Board (IRB) and HIPAA compliant.

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Yeh, K.J., Husseini, J.S., Hemke, R. et al. CT-guided discitis-osteomyelitis biopsies with negative microbiology: how many days should we wait before repeating the biopsy?. Skeletal Radiol 49, 619–623 (2020). https://doi.org/10.1007/s00256-019-03344-4

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  • DOI: https://doi.org/10.1007/s00256-019-03344-4

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