Laboratory diagnosis of postoperative sepsis of the musculoskeletal system

The diagnosis of acute sepsis after musculoskeletal surgery is based on the results of the clinical examination. Microbiologic evaluation of clinical specimens permits identification of the causal organism(s) and of the susceptibility studies. In the subacute stage of postoperative sepsis, roentgenographic examination, a peripheral leukocyte count, erythrocyte sedimentation rate, hemoglobin level, and nuclear scans can be helpful to the clinician. Frozen section histologic examination of tissues and Gram staining of fluids obtained at surgery have resolved the choice in differential diagnosis between aseptic and septic loosening of painful prosthetic components. Laboratory evaluation, including tissue biopsy, identifies the chronic complications of amyloidosis and malignant change in patients with long term sepsis of the musculoskeletal system.