Primary Sternal Osteomyelitis with Bacteremia and Distal Seeding

Platt, Melissa; Ziegler, Kevin

doi:10.1016/j.jemermed.2011.03.019

Cited by 15 publications

(20 citation statements)

References 7 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Kurihara

Kashiura

Moriya

et al. 2020

J of Gen and Family Med

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An 82‐year‐old man with untreated diabetes mellitus (DM) had anterior chest wall swelling and ulcers 2 years following blunt chest trauma. Contrast‐enhanced computed tomography revealed sternal fracture with osteolytic change and subcutaneous abscess. Blood and sternal cultures were positive for methicillin‐susceptible Staphylococcus aureus (MSSA). Transesophageal echocardiogram showed vegetation on the right coronary cusp and moderate aortic regurgitation. The patient received a diagnosis of infective endocarditis associated with chronic sternal osteomyelitis complicated by subcutaneous abscess because of MSSA. This case report showed that trivial trauma in patients with uncontrolled DM can cause chronic sternal osteomyelitis resulting in infective endocarditis.

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Section: Discussionmentioning

confidence: 99%

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

Kurihara

Kashiura

Moriya

et al. 2020

J of Gen and Family Med

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“…However, these symptoms are non-specific and may not always be present. Owing to the rarity of the disease and its non-specific symptoms, early diagnosis and appropriate treatment are often delayed [ 1 ]. Since our patient did not have any mass-like lesion, redness, or swelling in the sternal area, we had to differentiate between cardiogenic and non-cardiogenic causes of chest pain.…”

Section: Discussionmentioning

confidence: 99%

“…Sternal osteomyelitis usually occurs after cardiac surgery or chest trauma and is called secondary sternal osteomyelitis [ 1 ]. In contrast, primary sternal osteomyelitis (PSO) has no contiguous focus of infection, which is uncommon; it occurs in intravenous drug abusers and patients with diabetes or those infected with human immunodeficiency virus (HIV), which predisposes individuals to infection [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Primary Sternal Osteomyelitis caused byStaphylococcus aureusin an Immunocompetent Adult

et al. 2017

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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.

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“…Other cases of sternal osteomyelitis involve an immunodeficiency with some kind of entrance point 6. Abscess appears to be common, as it featured in multiple cases of sternal osteomyelitis 7. Other cases of sternal osteomyelitis after incidental trauma have been reported, even after cardiopulmonary resuscitation involving compressions 8,9.…”

Section: Discussionmentioning

confidence: 99%

Another cause of chest pain: Staphylococcus aureus sternal osteomyelitis in an otherwise healthy adult

Vacek¹,

Rehman²,

Yu³

et al. 2014

IMCRJ

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Chest pain requires a detailed differential diagnosis with good history-taking skills to differentiate between cardiogenic and noncardiogenic causes. Moreover, when other symptoms such as fever and elevated white blood cell count are involved, it may be necessary to consider causes that include infectious sources. A 53-year-old female with no significant past medical history returned to the hospital with recurrent complaints of chest pain that was constant, substernal, reproducible, and exacerbated with inspiration and expiration. The chest pain was thought to be noncardiogenic, as electrocardiography did not demonstrate changes, and cardiac enzymes were found to be negative for signs of ischemia. The patient’s blood cultures were analyzed from a previous admission and were shown to be positive for Staphylococcus aureus. The patient was started empirically on vancomycin, which was later switched to ceftriaxone as the bacteria were more sensitive to this antibiotic. A transthoracic echocardiogram did not demonstrate any vegetation or signs of endocarditis. There was a small right pleural effusion discovered on X-ray. Therefore, computed tomography as well as magnetic resonance imaging of the chest were performed, and showed osteomyelitis of the chest. The patient was continued on intravenous ceftriaxone for a total of 6 weeks. Tests for HIV, hepatitis A, B, and C were all found to be negative. The patient had no history of childhood illness, recurrent infections, or previous trauma to the chest, and had had no recent respiratory infections, pneumonia, or any underlying lung condition. Hence, her condition was thought to be a case of primary sternal osteomyelitis without known cause.

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Primary Sternal Osteomyelitis with Bacteremia and Distal Seeding

Cited by 15 publications

References 7 publications

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

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

Primary Sternal Osteomyelitis caused byStaphylococcus aureusin an Immunocompetent Adult

Another cause of chest pain: Staphylococcus aureus sternal osteomyelitis in an otherwise healthy adult

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