hematogenous vertebral osteomyelitis due to staphylococcus aureus in the adult clinical features and therapeutic outcomes objective staphylococcus aureus is the most common cause of hematogenous vertebral osteomyelitis in adults to better define clinical features and therapeutic outcomes the charts of 40 adult patients with s aureus hematogenous vertebral osteomyelitis were retrospectively reviewedmethods retrospective chart review using standardized data collection formresults s aureus hematogenous vertebral osteomyelitis commonly occurred in the settings of recent invasive procedures 55 of patients insulin use 28 and hemodialysis 20 ten percent of patients had s aureus bacteremia or vascular catheter infection within the preceding 6 months median time from first symptom to diagnosis was 513 days a portal of entry for s aureus was identified in 13 patients 325 intravenous catheters were the likely origin in 9 of those 13 patients concurrent endocarditis was present in 4 patients fortyeight percent of patients had neurologic abnormalities and 60 of patients had an epidural paraspinous or psoas abscess demonstrated by neuroimaging s aureus was isolated through fineneedle aspiration in 17 of 23 patients 74 and from blood cultures in 23 of 34 patients 68 infection was due to methicillinsusceptible s aureus in 675 of patients all patients received intravenous antibiotics for a mean duration of 586 days 36 of 40 90 also received concomitant rifampin twentyseven percent and 125 of patients underwent surgical debridement and ctguided drainage of abscesses respectively after intravenous therapy 19 of 30 eligible patients received oral continuation treatment the mean duration of total antibiotic therapy was 1422 daysconclusions cure of infection was achieved in 83 2429 of evaluable patients but 50 of those achieving cure still had infectionrelated sequelae intravenous antibiotic therapy for at least 8 weeks was the only clinical factor associated with cure p 005 twotailed fisher exact test