Primary Salmonella Osteomyelitis of the Sternum

Osteomyelitis is a rarely encountered diagnosis in children. It typically occurs due to hematogenous inoculation following transient bacteremia, with bacterial infection ultimately establishing in areas of microtrauma. Prevalence is highest in long bones due to active marrow, and the most common organism isolated from affected tissue is Staphylococcus aureus. Patients with hemoglobinopathies, however, are more susceptible to unusual pathogens, particularly Salmonella species. This report summarizes the successful management of a unique presentation of primary Salmonella osteomyelitis of the sternum in a patient heterozygous for the hemoglobin E trait and opens the discussion for a potential biological basis of disease.