Infections simulating bone tumors. A review of subacute osteomyelitis.

The problem of differentiating primary bone tumors from subacute osteomyelitis was reviewed in 15 typical cases. Presenting symptoms, duration of illness, admitting laboratory data, and location of the pathologic condition were of little assistance in diagnosis. Preoperative diagnoses included benign and malignant neoplasms as well as osteomyelitis. In all cases the final diagnosis of subacute osteomyelitis was made only after open biopsy. Surgical curettage combined with appropriate antibiotic therapy was deemed essential for adequate treatment of this infectious process. Drug therapy included three to six weeks of parenteral antibiotics followed by three to six weeks of oral antibiotics. The protocol for duration of antibiotic therapy was based on the type of bacteria, the antibiotic serum levels achievable via the oral route, and patient compliance.