How would you manage a frail but functioning elderly patient with extensive thoracolumbar spinal fusions 4-5 years ago now presenting with copious purulent drainage from L2-L4 whose MRI shows no osteomyelitis or abscess, and who has mild pain but no systemic signs or symptoms of illness?

Answer from: at Academic Institution

I would see if there is any way to get a culture (not a swab of the purulence, but maybe a bedside procedure where a deeper sample can be taken without requiring anesthesia). Once I have the culture, I would target the bacteria isolated and give chronic lifelong suppressive oral antibiotic therapy t...

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How would you manage a frail but functioning elderly patient with extensive thoracolumbar spinal fusions 4-5 years ago now presenting with copious purulent drainage from L2-L4 whose MRI shows no osteomyelitis or abscess, and who has mild pain but no systemic signs or symptoms of illness?

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