Primary Sternal Osteomyelitis caused byStaphylococcus aureusin an Immunocompetent Adult

Abstract

Primary sternal osteomyelitis (PSO) is a rare condition that may develop without any contiguous focus of infection. Due to the rarity of the disease, early diagnosis and appropriate treatment are often delayed. Herein, we describe a patient with PSO caused by Staphylococcus aureus that presented with chest pain and fever. The patient had no predisposing factors for sternal osteomyelitis. The chest pain was thought to be non-cardiogenic, as electrocardiography and cardiac enzyme did not reveal ischemic changes when he visited the emergency room. After blood culture revealed the presence of S. aureus, every effort was made to identify the primary focus of infection. Bone scan and magnetic resonance imaging revealed osteomyelitis with soft tissue inflammation around the sternum. After 8 weeks of antibiotics treatment, the patient recovered without any complications.

Primary Sternal Osteomyelitis Caused by Methicillin-Sensitive Staphylococcus aureus: A Diagnosis Rare in Healthy Adults

“…It can develop through three different mechanisms: hematogenous dissemination in the setting of bacteremia; contiguous spread of infection from adjacent soft tissues and joints, such as in the case of diabetic foot wounds; or through direct penetration of a microorganism after trauma or surgery [ 4 ]. There are many risk factors associated with hematogenous osteomyelitis, the most common being intravenous drug use, diabetes mellitus, immunodeficiency, subclavian vein catheterization, or liver cirrhosis [ 5 - 6 ]. Among adults, the most frequent form of hematogenous osteomyelitis is vertebral osteomyelitis [ 5 ].…”

“…Among adults, the most frequent form of hematogenous osteomyelitis is vertebral osteomyelitis [ 5 ]. In contrast, PSO is an extremely rare condition, being responsible for only 0.3% of all cases of osteomyelitis [ 6 ].…”

“…PSO commonly presents as chest pain, tenderness, swelling, warmth, and erythema of the anterior thoracic wall, associated with fever and chills [ 6 ]. When our patient presented to the ED for the first time, his main complaint was chest pain.…”

Sternal osteomyelitis and infective endocarditis after old trivial chest trauma in untreated diabetes mellitus: A case report

“…The present patient's long‐term history of DM probably contributed to promoting S aureus infection. Two cases of sternal osteomyelitis causing bacteremia and knee abscesses have been reported; however, sternal osteomyelitis rarely causes disseminated lesions 8,9 . Smit et al 10 reported an association between DM and community‐acquired S aureus bacteremia, particularly in patients with long‐term DM, poor glycemic control, or complications of diabetes.…”

A Case of Primary Sternomanubrial Osteomyelitis With Oxacillin-Resistant Staphylococcus aureus (ORSA) Bacteremia

“…Primary sternomanubrial osteomyelitis (PSO) is an unusual entity in healthy adults and sternal osteomyelitis represents 0.3% among all cases of osteomyelitis (OM) [1][2][3]. Manubrial osteomyelitis has been described once in the literature, was secondary to tuberculosis and complicated by abscess formation [4].…”