Infection biopsies

For INFECTION biopsies (osteomyelitis, discitis/osteomyelitis) and aspirations (abscess, septic arthritis): 

a. Purple top contains inhibitors/anticoagulants, use only for cell counts and joint crystals; you can send the culture in the syringe (expel air, add dead head).

b. Try to send 2 separate samples to microbiology with two separate tubes and two separate forms. Label each form and tube/label with “#1” or”#2” and write on the form “please culture separately from sample #1 (or 2) from this patient” (otherwise they will just pour them together and combine). Sandy Nelson from ID suggests this will decrease false positives and false negatives. 

• • • See Figure 1 for the orders needed.

    • If you are in Ellison 2 CT, the technologist can save you the pain of printing out ALL the orders on separate pieces of paper from Epic using the method detailed in Figure 2

c. Sent pathology if possible!

• Sacroiliac joint sampling is done under CT