Clinical differences between monomicrobial and polymicrobial vertebral osteomyelitis

Little literature exists examining differences in presentation and outcomes between monomicrobial and polymicrobial vertebral infections. Seventy-nine patients treated for vertebral osteomyelitis between 2001 and 2011 were reviewed. Patients were divided into monomicrobial and polymicrobial cohorts based on type of infection. Various characteristics were compared between the 2 groups. The 26 patients with a polymicrobial infection were older and had a higher mortality rate, lower clearance of infection, larger infection, more vertebral instability, higher erythrocyte sedimentation rate at presentation, and longer mean length of stay. There were no significant differences in Oswestry Disability Index scores at final followup, but there were differences in presentation and clinical outcomes between monomicrobial and polymicrobial vertebral osteomyelitis. Patients may benefit from counseling regarding their disease type and potential prognosis.