Role of ultrasound and CT in the early diagnosis and surgical treatment of primary sternal osteomyelitis caused by <em>Salmonella</em>: Case reports

Qian,Mengjiao; Wang,Jing; Li,Jun; Wang,Sibo; Wang,Zhongyin; Chen,Xiao; Ou,Haibo; Liang,Yuanzhong; Peng,Xuguan

doi:10.3892/etm.2021.9620

March-2021 Volume 21 Issue 3

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March-2021 Volume 21 Issue 3

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Case Report Open Access

Role of ultrasound and CT in the early diagnosis and surgical treatment of primary sternal osteomyelitis caused by Salmonella: Case reports

Authors:
- Mengjiao Qian
- Jing Wang
- Jun Li
- Sibo Wang
- Zhongyin Wang
- Xiao Chen
- Haibo Ou
- Yuanzhong Liang
- Xuguan Peng
View Affiliations / Copyright

Affiliations: Department of Cardiothoracic Surgery, The First People's Hospital of Honghe Prefecture, Mengzi, Yunnan 661100, P.R. China, Department of Radiology, The First People's Hospital of Honghe Prefecture, Mengzi, Yunnan 661100, P.R. China

Copyright: © Qian et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Article Number: 189
|
Published online on: January 7, 2021

https://doi.org/10.3892/etm.2021.9620
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Abstract

Primary sternal osteomyelitis (PSO) caused by Salmonella is a rare condition and most commonly associated with sickle cell disease. Only one such case has been previously reported in an infant (age, <1 year) worldwide. The present study reported on two infantile cases of PSO caused by Salmonella in the absence of any hematological diseases. A total of two male infants (age, ≤1 year) were referred to our hospital for fever and rapid breathing accompanied by a chest wall mass involving the lower end of the sternum. Imaging findings on CT and ultrasound, which included sternal segment dislocation, lytic destruction and periosteal elevation, confirmed the diagnosis of PSO. Blood and purulent material cultures confirmed that the causative pathogen was Salmonella. The infants were completely cured by sequential intravenous and oral antibiotics followed by surgical debridement. The infants remained symptom‑free and local recurrence of PSO was not detected at follow‑up. PSO caused by Salmonella in the absence of any hematological diseases is a rare condition. Unfamiliarity with this disease may lead to a delay in diagnosis and serious complications. The current case report presents two cases of PSO along with a brief overview of the characteristics and management modalities for this condition, and it provides a comprehensive reference for pediatricians regarding this rare disease, particularly in infants.

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1	Araiza-Garaygordobil D, Soto-Nieto GI, Aguilar-Rojas LA and Catrip J: Primary sternal osteomyelitis caused by Salmonella enteritidis. Enferm Infecc Microbiol Clin. 35:60–62. 2017.PubMed/NCBI View Article : Google Scholar
2	Pettas NS, Apostolopoulos AP, Flieger I and Leonidou O: Primary sternal osteomyelitis in a 40 days old infant: A case report and review of the literature. Cases J. 2(7504)2009.PubMed/NCBI View Article : Google Scholar
3	Sayed S, Prabhu S, Thomas M, McBride CA and Alphonso N: Primary sternal osteomyelitis with extensive mediastinal abscess in a neonate. Ann Thorac Surg. 100:e85–e87. 2015.PubMed/NCBI View Article : Google Scholar
4	Schweitzer A, Della Beffa C, Akmatov MK, Narchi H, Abaev YK, Sherry DD and Pessler F: Primary osteomyelitis of the sternum in the pediatric age group: Report of a new case and comprehensive analysis of seventy-four cases. Pediatr Infect Dis J. 34:e92–e101. 2015.PubMed/NCBI View Article : Google Scholar
5	Bryant R III, Morales DL and Phalak K: Multimodality therapy for primary sternal osteomyelitis. Pediatr Infect Dis J. 28:73–74. 2009.PubMed/NCBI View Article : Google Scholar
6	Muesse JL, Blackmon SH, Ellsworth WA IV and Kim MP: Treatment of sternoclavicular joint osteomyelitis with debridement and delayed resection with muscle flap coverage improves outcomes. Surg Res Pract. 2014(747315)2014.PubMed/NCBI View Article : Google Scholar
7	Thomson RM, Henderson HJ and Smith-Palmer A: An outbreak of Salmonella Saintpaul in a Scottish childcare facility: The influence of parental under-reporting. BMC Infect Dis. 19(847)2019.PubMed/NCBI View Article : Google Scholar
8	Ngogo FA, Joachim A, Abade AM, Rumisha SF, Mizinduko MM and Majigo MV: Factors associated with Salmonella infection in patients with gastrointestinal complaints seeking health care at Regional Hospital in Southern Highland of Tanzania. BMC Infect Dis. 20(135)2020.PubMed/NCBI View Article : Google Scholar
9	Crone AM, Wanner MR, Cooper ML, Fox TG, Jennings SG and Karmazyn B: Osteomyelitis of the ribs in children: A rare and potentially challenging diagnosis. Pediatr Radiol. 50:68–74. 2020.PubMed/NCBI View Article : Google Scholar
10	Llewellyn A, Jones-Diette J, Kraft J, Holton C, Harden M and Simmonds M: Imaging tests for the detection of osteomyelitis: A systematic review. Health Technol Assess. 23:1–128. 2019.PubMed/NCBI View Article : Google Scholar
11	Lu CH, Hsiao YF, Hsu HC, Ko YL, Lin TS, Chen LF, Hsieh SC and Li KJ: Can ultrasound differentiate acute erosive arthritis associated with osteomyelitis, rheumatoid arthritis, or gouty arthritis? Int J Rheum Dis. 22:1972–1977. 2019.PubMed/NCBI View Article : Google Scholar
12	Sammak B, Abd El Bagi M, Al Shahed M, Hamilton D, Al Nabulsi J, Youssef B and Al Thagafi M: Osteomyelitis: A review of currently used imaging techniques. Eur Radiol. 9:894–900. 1999.PubMed/NCBI View Article : Google Scholar
13	Ecury-Goosssen GM, Huysman MA, Verhallen-Dantuma JC and Man P: Sequential intravenous-oral antibiotic therapy for neonatal osteomyelitis. Pediatr Infect Dis J. 28:72–73. 2009.PubMed/NCBI View Article : Google Scholar
14	Joshi P, Bavdekar SB and Save SU: A swelling over sternum in a child: Reminder of an uncommon diagnosis. Case Rep Pediatr. 2016(3765786)2016.PubMed/NCBI View Article : Google Scholar
15	Singal R, Singh P, Mittal A, Gupta S, Singla S and Kenwar DB: Primary sternal tuberculous ulcer with dissemination to the bone marrow: A clinical rarity. Ann Saudi Med. 31:542–545. 2011.PubMed/NCBI View Article : Google Scholar