{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T14:08:50Z","timestamp":1785247730104,"version":"3.55.0"},"reference-count":17,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,7,13]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>\n                    Primary sternal osteomyelitis (PSO) is an exceptionally rare infection of the sternum, typically occurring in the context of trauma, surgery or immunocompromise. We report the case of a previously healthy adolescent boy in his second decade of life presenting with fever, chest pain and localised tenderness without any identifiable risk factors. Initial workup, including a chest X-ray and echocardiogram, was unremarkable, but persistent bacteraemia with methicillin-sensitive\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    prompted further imaging. MRI revealed sternal osteomyelitis with a small parasternal abscess. The patient was successfully treated with intravenous antibiotics alone, avoiding surgical intervention. This case highlights the importance of thorough physical examination and maintaining a high index of suspicion for PSO in patients with unexplained fever and chest wall tenderness, even in the absence of traditional risk factors. Early diagnosis and targeted therapy are essential to optimise outcomes in this rare condition.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2026-272711","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T13:30:14Z","timestamp":1785245414000},"page":"e272711","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Idiopathic primary sternal osteomyelitis in an otherwise healthy patient"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4792-9338","authenticated-orcid":false,"given":"Adam","family":"Henderson","sequence":"first","affiliation":[{"name":"College of Medicine and Science, Mayo Clinic Alix School of Medicine Arizona Campus, Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siya","family":"Bhutani","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine, Gainesville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8150-0098","authenticated-orcid":false,"given":"Suraj","family":"Singh","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine - Jacksonville, Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"2026072806300770000_19.7.e272711.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2017.01.010"},{"key":"2026072806300770000_19.7.e272711.2","article-title":"Primary sternal osteomyelitis","volume":"121","author":"Rodr\u00edguez Lorenzo","year":"2023","journal-title":"Arch Argent Pediatr"},{"key":"2026072806300770000_19.7.e272711.3","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-011-0171-z"},{"key":"2026072806300770000_19.7.e272711.4","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1097\/SMJ.0b013e3181b201f8","article-title":"Sternal osteomyelitis after minor trauma","volume":"102","author":"Edelman","year":"2009","journal-title":"South Med J"},{"key":"2026072806300770000_19.7.e272711.5","doi-asserted-by":"crossref","first-page":"3019","DOI":"10.1016\/j.radcr.2022.05.086","article-title":"Culture-negative primary sternal osteomyelitis in a patient with uncontrolled type 2 diabetes mellitus","volume":"17","author":"Chan","year":"2022","journal-title":"Radiol Case Rep"},{"key":"2026072806300770000_19.7.e272711.6","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(91)91232-K"},{"key":"2026072806300770000_19.7.e272711.7","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/0736-4679(94)90269-0","article-title":"Primary sternal osteomyelitis","volume":"12","author":"Shukla","year":"1994","journal-title":"J Emerg Med"},{"key":"2026072806300770000_19.7.e272711.8","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1378\/chest.63.2.236","article-title":"Primary sternal osteomyelitis","volume":"63","author":"Biesecker","year":"1973","journal-title":"Chest"},{"key":"2026072806300770000_19.7.e272711.9","doi-asserted-by":"crossref","DOI":"10.1097\/GOX.0000000000002120","article-title":"Primary Sternal Osteomyelitis: A Case Report and Review","volume":"7","author":"Lopez","year":"2019","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"2026072806300770000_19.7.e272711.10","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e3181e0c928"},{"key":"2026072806300770000_19.7.e272711.11","doi-asserted-by":"crossref","first-page":"e92","DOI":"10.1097\/INF.0000000000000597","article-title":"Primary osteomyelitis of the sternum in the pediatric age group: report of a new case and comprehensive analysis of seventy-four cases","volume":"34","author":"Schweitzer","year":"2015","journal-title":"Pediatr Infect Dis J"},{"key":"2026072806300770000_19.7.e272711.12","first-page":"589","article-title":"Septic Arthritis: Diagnosis and Treatment","volume":"104","author":"Earwood","year":"2021","journal-title":"Am Fam Physician"},{"key":"2026072806300770000_19.7.e272711.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.micpath.2009.04.007"},{"key":"2026072806300770000_19.7.e272711.14","doi-asserted-by":"crossref","first-page":"177S","DOI":"10.1097\/PRS.0b013e3182001f0f","article-title":"Treating osteomyelitis: antibiotics and surgery","volume":"127 Suppl 1","author":"Rao","year":"2011","journal-title":"Plast Reconstr Surg"},{"key":"2026072806300770000_19.7.e272711.15","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1093\/jpids\/piab027","article-title":"Clinical Practice Guideline by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America: 2021 Guideline on Diagnosis and Management of Acute Hematogenous Osteomyelitis in Pediatrics","volume":"10","author":"Woods","year":"2021","journal-title":"J Pediatric Infect Dis Soc"},{"key":"2026072806300770000_19.7.e272711.16","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.11321","article-title":"Use of Novel Strategies to Develop Guidelines for Management of Pyogenic Osteomyelitis in Adults: A WikiGuidelines Group Consensus Statement","volume":"5","author":"Spellberg","year":"2022","journal-title":"JAMA Netw Open"},{"key":"2026072806300770000_19.7.e272711.17","doi-asserted-by":"crossref","unstructured":"Godon J , Sow A-K , Das Neves S , et al . 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