In more serious cases, a bacteremia can result, causing an osteomyelitis or endocarditis. Open fractures can result in infection, osteomyelitis, and sepsis. On occasion, it causes cellulitis, osteomyelitis, and infectious arthritis. As of 2012, if rifampicin combination therapy was useful for pyogenic vertebral osteomyelitis was unclear. Other entities with similar clinical presentations include osteomyelitis, osteosarcoma (especially telangiectatic osteosarcoma), and eosinophilic granuloma. Other complications include sinobronchitis, maxillary osteomyelitis, and frontal bone osteomyelitis. Similarly, it is limited in distinguishing bone infarcts from osteomyelitis in sickle cell anemia. Surgery may be required for patients with advanced cases of vertebral osteomyelitis. Vertebral osteomyelitis is most commonly caused by staphylococci. Fractures and osteomyelitis can be treated as usual. No evidence was found of stress fracture or infectious processes like osteomyelitis or infectious periostitis. Vertebral osteomyelitis is another possible presentation. "Staphylococcus aureus" is the organism most commonly isolated from all forms of osteomyelitis. Hematogenous spread of bacteria is responsible for many bone infections (osteomyelitis). The "Burkholderia cepacia" complex has been implicated in vertebral osteomyelitis in intravenous drug users.