1. most common organism is Staphylococcus aureus
  2. Salmonella typhi in patients with sickle cell disease
  3. In neonates and immunocompromised patients Gram-negative organisms (H. influenzae) are more common.
  4. In IV drug abusers – E. Coli, Pseudomonas, Klebsiella

Clinical Presentation

  • Most commonly localized extremity pain ± fever, erythema or swelling, 1 to 2 wks after respiratory infection or infection at another non-bony site
  • common sites: long bones (children), vertebrae (adults)


  • bone biopsy, blood culture, aspirate cultures, ESR, CRP, CBC (leukocytosis)
  • x-ray, bone scan (increased uptake within 24-48 h after onset in majority of patients)
  • MRI most sensitive/specific (use for diabetic foot ulcer or vertebral involvement )

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