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Primary sternal osteomyelitis with bacteremia and distal seeding
Melissa A Platt1, Kevin Ziegler
1Department of Emergency Medicine, School of Medicine, University of Louisville, Louisville, Kentucky, USA.
The Journal of Emergency Medicine
|April 29, 2011
Summary
Primary sternal osteomyelitis is a rare infection, often challenging to diagnose. This case highlights Staphylococcus aureus sternal osteomyelitis in an immunocompetent patient, complicated by abscesses.
Area of Science:
- Infectious Diseases
- Osteomyelitis Research
- Surgical Infections
Background:
- Primary sternal osteomyelitis is a rare condition.
- Secondary sternal osteomyelitis is a known complication post-sternotomy.
- Distinguishing primary from secondary sternal osteomyelitis is crucial for appropriate management.
Observation:
- A 46-year-old immunocompetent male presented with persistent sternal pain, swelling, fatigue, and fever.
- Clinical presentation suggested primary sternal osteomyelitis.
- Computed tomography (CT) imaging was instrumental in diagnosis.
Findings:
- The patient was diagnosed with primary Staphylococcus aureus sternal osteomyelitis.
- Concurrent bacteremia was identified.
- Complications included local and distant abscess formation.
Implications:
- Primary sternal osteomyelitis is uncommon and diagnostically challenging.
- Radiography and detailed patient history aid diagnosis.
- Treatment involves prolonged antibiotics and surgical intervention (incision and drainage).
- Potential complications include abscesses and distant infections.
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