Primary sternal osteomyelitis: a case series and review of the literature

Upadhyaya, Manasvi; Keil, Anthony D.; Thonell, Sven; Orford, Jillian; Burgner, David

doi:10.1016/j.jpedsurg.2005.06.019

Cited by 21 publications

(11 citation statements)

References 16 publications

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“…It may occur in patients with a history of intravenous drug abuse (44), acquired immunodeficiency syndrome, hemoglobinopathy, or other immune deficiency states (45). Although Staphylococcus aureus infection is the most common cause of sternal osteomyelitis (46), other infectious causes, including Salmonella species (in patients with sickle cell disease), Pseudomonas aeruginosa (among intravenous drug abusers), Candida albicans, Aspergillus fumigatus, and Mycobacterium tuberculosis, have been reported (43)(44)(45)(46)(47). Blastomycosis and actinomycosis radiographics.rsnajnls.org also may cause osteomyelitis of the sternum (48).…”

Section: Infectious Processes Primary and Secondary Osteomyelitismentioning

confidence: 99%

Imaging Appearances of the Sternum and Sternoclavicular Joints

Restrepo¹,

Martínez²,

Lemos³

et al. 2009

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The sternum and sternoclavicular joints--critical structures of the anterior chest wall--may be affected by various anatomic anomalies and pathologic processes, some of which require treatment. Pectus excavatum and pectus carinatum are common congenital anomalies that are usually benign but may warrant surgical treatment if they cause compression of vital internal structures. By contrast, developmental variants such as the sternal foramen are asymptomatic and do not require further evaluation or treatment. Arthritides of the sternoclavicular joint (osteoarthritis, septic arthritis, and seronegative arthropathies) are common and must be differentiated before an appropriate management method can be selected. The recognition of complications of sternotomy (eg, sternal dehiscence, secondary osteomyelitis) is critical to avoid life-threatening sequelae such as acute mediastinitis. Likewise, the detection of sternal fractures and sternoclavicular dislocations is important, especially where they impinge on vital structures. In addition, sternal malignancies (most commonly, metastases and chondrosarcoma) must be distinguished from benign neoplasms. To achieve accurate and timely diagnoses that facilitate appropriate treatment, radiologists must be familiar with the appearances of these normal anatomic variants and diseases of the sternum.

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Section: Infectious Processes Primary and Secondary Osteomyelitismentioning

confidence: 99%

Imaging Appearances of the Sternum and Sternoclavicular Joints

Restrepo¹,

Martínez²,

Lemos³

et al. 2009

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170

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“…S. aureus and Salmonella (in sickle cell disease patients) are the commonest causes [10]. We were able to find, in the English literature, two pediatric PSO cases caused by communityacquired methicillin-resistant S. aureus.…”

Section: Discussionmentioning

confidence: 96%

“…We were able to find, in the English literature, two pediatric PSO cases caused by communityacquired methicillin-resistant S. aureus. [10].…”

Section: Discussionmentioning

confidence: 99%

Primary sternal osteomyelitis caused by Nocardia nova: case report and literature review

Baraboutis¹,

Argyropoulou²,

Papastamopoulos³

et al. 2008

Braz J Infect Dis

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A 51 year old woman without significant past medical history or risk factors for Nocardia infection developed primary Nocardia nova sternal osteomyelitis with mediastinal abscess, diagnosed with open biopsy. She required prolonged antibiotic therapy and had a favorable outcome. Primary sternal osteomyelitis develops in the absence of a contiguous focus of infection, as opposed to secondary sternal osteomyelitis, which is usually a complication of sternotomy. Staphylococcus aureus probably still is the most common cause of both forms of sternal osteomyelitis. Nocardia species invade humans usually through the respiratory tract and can cause a variety of localized infections through the hematogenous route. Pulmonary involvement may or may not coexist. Immunosuppressed patients are more prone to infection by Nocardia species, although cases involving seemingly immunocompetent patients are not rare. This is the first reported case in the English literature of primary sternal osteomyelitis due to Nocardia nova or any other Nocardia species.

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“…The sternum is an uncommon site of infection, and most sternal infections are caused by staphylococci, followed by gram-negative organisms, pseudomonas, and aspergillus species [4]. Mycobacterial infections of the sternum are also very rare and usually develop secondary to sternotomy, immunosuppression, or Bacillus Calmette-Guérin (BCG) vaccination [5].…”

Section: Discussionmentioning

confidence: 99%

“…Unlike pyogenic sternal infections, which are characterized by a more rapid and fulminant course, tuberculous osteomyelitis of the sternum usually presents insidiously without constitutional symptoms as swelling and pain over the bone. The body of the sternum is most commonly involved, followed by the manubrium [3,4].…”

Section: Discussionmentioning

confidence: 99%