title: Primary sternal osteomyelitis caused by Nocardia nova: case report and literature review.
abstract: A 51 year old woman without significant past medical history or risk factors for Nocardia infection developed primary Nocardia nova sternal osteomyelitis with mediastinal abscess, diagnosed with open biopsy. She required prolonged antibiotic therapy and had a favorable outcome. Primary sternal osteomyelitis develops in the absence of a contiguous focus of infection, as opposed to secondary sternal osteomyelitis, which is usually a complication of sternotomy. Staphylococcus aureus probably still is the most common cause of both forms of sternal osteomyelitis. Nocardia species invade humans usually through the respiratory tract and can cause a variety of localized infections through the hematogenous route. Pulmonary involvement may or may not coexist. Immunosuppressed patients are more prone to infection by Nocardia species, although cases involving seemingly immunocompetent patients are not rare. This is the first reported case in the English literature of primary sternal osteomyelitis due to Nocardia nova or any other Nocardia species.
authors.affiliation: Department of Internal Medicine, Infectious Diseases & HIV Division, Evaggelismos Athens General Hospital, Athens, Greece. ioannisbaraboutis@yahoo.gr
authors.forename: Ioannis G
authors.initials: IG
authors.lastname: Baraboutis
authors.forename: Athena
authors.initials: A
authors.lastname: Argyropoulou
authors.forename: Vasilios
authors.initials: V
authors.lastname: Papastamopoulos
authors.forename: Zoi
authors.initials: Z
authors.lastname: Psaroudaki
authors.forename: Olga
authors.initials: O
authors.lastname: Paniara
authors.forename: Athanasios T
authors.initials: AT
authors.lastname: Skoutelis
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D009617:Nocardia Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D010019:Osteomyelitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D013249:Sternum / Q000382:microbiology*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D015662:Trimethoprim, Sulfamethoxazole Drug Combination