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      Primary Sternal Osteomyelitis caused by Staphylococcus aureus in an Immunocompetent Adult

      case-report

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          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.

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          Most cited references17

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          Imaging of osteomyelitis: current concepts.

          Osteomyelitis frequently requires more than one imaging technique for an accurate diagnosis. Conventional radiography still remains the first imaging modality. MRI and nuclear medicine are the most sensitive and specific methods for the detection of osteomyelitis. MRI provides more accurate information regarding the extent of the infectious process. Ultrasound represents a noninvasive method to evaluate the involved soft tissues and cortical bone and may provide guidance for diagnostic or therapeutic aspiration, drainage, or tissue biopsy. CT scan can be a useful method to detect early osseous erosion and to document the presence of sequestra. PET and SPECT are highly accurate techniques for the evaluation of chronic osteomyelitis, allowing differentiation from soft tissue infection.
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            Clinical Guidelines for the Antimicrobial Treatment of Bone and Joint Infections in Korea

            (2014)
            There are many various diseases in the bone and joint infections, and we tried to make antimicrobial treatment guidelines for common infectious diseases based on available data for microbiology and clinical trials. This guidelines focused on the treatment of osteomyelitis and septic arthritis, which can be experienced by physicians at diverse clinical settings. This guidelines is not applicable to diabetic foot infections, postoperative infections or post-traumatic infections which need special considerations. The guidelines for those conditions will be separately developed later. Surgical treatment of bone and joint infections, pediatric bone and joint infection, tuberculous bone and joint infection, and prophylactic antibiotic use were not included in this guideline.
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              Primary sternal osteomyelitis.

              A case report of primary sternal osteomyelitis, a rare clinical entity, is presented. Treatment of primary sternal osteomyelitis is antibiotics and complete debridement of the infected bone and anterior periosteum. If the posterior sternal periosteum is not involved, it should be left intact. The defect can be covered with skeletal muscle flaps, which improves healing and minimizes recurrence. This approach led to a complete and timely cure.
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                Author and article information

                Journal
                Infect Chemother
                Infect Chemother
                IC
                Infection & Chemotherapy
                The Korean Society of Infectious Diseases and Korean Society for Chemotherapy
                2093-2340
                2092-6448
                September 2017
                23 May 2017
                : 49
                : 3
                : 223-226
                Affiliations
                [1 ]Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
                [2 ]Department of Nuclear Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
                [3 ]Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
                Author notes
                Corresponding Author: Su-Mi Choi, MD, PhD. Department of Internal Medicine, Yeouido St. Mary’s Hospital, 10, 63-ro, Yeouido-dong, Yeongdeungpo-gu, Seoul 07345, Korea. Tel: +82-2-3779-1376, Fax: +82-2-780-3132, sumichoi@ 123456catholic.ac.kr
                Author information
                https://orcid.org/0000-0001-7813-0516
                https://orcid.org/0000-0002-8187-5110
                Article
                10.3947/ic.2017.49.3.223
                5620390
                28608656
                016a08bf-afcf-401d-8822-f1611c9fb251
                Copyright © 2017 by The Korean Society of Infectious Diseases and Korean Society for Chemotherapy

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 06 May 2016
                : 28 June 2016
                Categories
                Case Report

                immunocompetent host,osteomyelitis,sternum,staphylococcus aureus

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