Counterimmunoelectrophoresis and gel-diffusion techniques were used to
study the development of teichoic acid antibodies in eighteen patients with
osteomyelitis and seven patients with septic arthritis caused by
Staphylococcus aureus. Nine of eleven patients with acute osteomyelitis and
three of seven with chronic osteomyelitis had a positive response to tests
for teichoic acid antibody. However, only two of seven patients with septic
arthritis generated a positive teichoic-acid antibody response. In two
patients the test was extremely valuable in the diagnosis and management of
osteomyelitis. Antibody detection appears to be a sensitive test for
detecting staphylococcal osteomyelitis, especially the acute variety. It
does not appear to be a reliable test for septic arthritis. It is also
useful for the detection of antibody in patients who had received prior
antibiotic therapy, yet have persistent foci of infection. The presence of
the teichoic acid antibody, as well as its titer, is of diagnostic value in
patients with serious infections caused by Staphylococcus aureus. The
detection and quantification of teichoic acid antibodies is of great value
for the early diagnosis of patients with acute osteomyelitis caused by
Staphylococcus aureus and for assessing the clinical response of such
patients.