To the Editor. —
We read with interest the article by Sinnott and colleagues1 on tuberculous osteomyelitis masked by concomitant staphylococcal infection that appeared in the September 1990 issue of the Archives. We would like to offer our experience in Spain, a country where tuberculosis is still a public health problem.Of the 127 cases of hematogenous osteomyelitis studied in our center between 1978 and 1985,22Mycobacterium tuberculosis was found in 52 patients (40.9%) and Staphylococcus aureus in 48 patients (37.7%). Polymicrobial pathogens were noted in seven cases (5.5%), with S aureus and M tuberculosis coinciding in three of them. The high rate of osseous tuberculosis in our series could be partially due to the fact that we are a referral unit for tuberculosis patients in our hospital; but in any case, these data outline the importance of M tuberculosis as a causative factor in osteomyelitis in Spain.