Can you have osteomylitis in your spine and still have a negative blood culture?

Yes.: Localized infections often have negative blood culture.

Yes: Vertebral osteomyelitis is usually acquired after surgery on the spine or by hematogenous or blood stream spread. The bacteria are only in the bloodstream intermittently so blood cultures can be positive or sterile. Patients with more continuous bacteremia often have underlying heart valve infections, endocarditis.