Diagnosis
Cold abscess of the bone, diagnosis often made on x-ray's that were obtained due to pain. Most often in the middle of long bones, an odd place for osteomyelitis.
Epidemiologic Risks
S. aureus bacteremia, often occult.
Microbiology
Empiric Therapy
Debride, then nafcillin/oxacillin or vancomycin.
Specific Therapy
Treat as osteomyelitis with six weeks of iv therapy after debridement (PubMed).
Pearls
The diagnosis is often a surprise, it will be thought to be a bone tumor.
Sometimes they will form a tract and start to drain.
Named after Sir Benjamin Collins Brodie, 1st Baronet who first wrote about it in the 1830s.
Curious Cases
Relevant links to my Medscape blog
Last Update: 05/23/18.