Primary sternal osteomyelitis due to Peptostreptococcus anaerobius

Area of Science:

• Infectious Diseases
• Bacteriology
• Surgical Pathology

Background:

• Primary sternal osteomyelitis (PSO) is an uncommon infection, often associated with compromised immunity or intravenous drug use.
• Common causative agents include Staphylococcus aureus and Pseudomonas aeruginosa.
• Peptostreptococcus species are commensal Gram-positive anaerobic cocci found on human mucocutaneous surfaces.

Observation:

• A previously healthy 32-year-old man presented with PSO.
• Bacterial cultures from the sternal infection yielded Peptostreptococcus anaerobius.
• Initial empirical antibiotic treatment proved ineffective.

Findings:

• Peptostreptococcus anaerobius can be a causative agent of primary sternal osteomyelitis.
• Successful treatment of PSO caused by P. anaerobius may require a combination of antibiotics and surgical debridement.
• This case demonstrates a rare instance of PSO in an immunocompetent patient.

Implications:

• Highlights the importance of considering anaerobic bacteria, such as Peptostreptococcus anaerobius, in the differential diagnosis of PSO, even in previously healthy individuals.
• Suggests that surgical intervention, in addition to antibiotics, may be crucial for managing specific cases of sternal osteomyelitis.
• Expands the understanding of potential pathogens involved in PSO and their treatment outcomes.