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Osteolytic lesion indicating Pseudomonas sternal osteomyelitis

A K Mandal, M Fiala, S S Oparah

Archives of Surgery (Chicago, Ill. : 1960)

|July 1, 1976

Summary

Pseudomonas aeruginosa caused rare sternal osteolytic lesions in two heroin users following trauma. Cure was achieved with bone curettage and antibiotics, including tobramycin sulfate, avoiding sternal excision.

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Area of Science:

Infectious Diseases
Osteomyelitis
Medical Microbiology

Background:

Osteolytic lesions of the sternum are uncommon, with diverse etiologies.
Delayed post-traumatic infections can present insidiously.
Pseudomonas aeruginosa is an opportunistic pathogen, particularly in immunocompromised individuals or those with specific risk factors.

Observation:

Two cases of sternal osteolytic lesions were identified.
Both patients were intravenous heroin users.
Lesions appeared as a delayed reaction to prior sternal trauma from an automobile accident.

Findings:

Infection was confirmed to be caused by Pseudomonas aeruginosa.
Surgical intervention (excision) was not required for successful treatment.

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Conservative management involving bony curettage and antibiotic therapy proved effective.

Tobramycin sulfate, a novel aminoglycoside, demonstrated successful therapeutic outcomes in both patients.

Implications:

Highlights the potential for Pseudomonas aeruginosa to cause rare sternal osteomyelitis in specific patient populations.
Demonstrates the efficacy of conservative surgical and antibiotic management for such infections.
Suggests tobramycin sulfate as a viable treatment option for Pseudomonas aeruginosa-induced osteolytic bone lesions.