CTICasesChest Wall Abscesses and Osteomyelitis Secondary to Trauma and Bacteremia
Imaging findings
Contrast-enhanced chest CT shows an extensive, multiloculated extrapleural fluid collection and abscess in the left anterior chest wall, with gas and fluid pockets dissecting into the pectoralis major and adjacent musculature. There is also an associated displaced sternal body fracture and fractures of the first and second ribs.
Key takeaways
In intravenous drug users with pre-existing Staph bacteremia, acute traumatic bone injuries, such as sternal or rib fractures, can act as a locus of reduced resistance, facilitating hematogenous seeding and the rapid development of osteomyelitis and extensive soft-tissue abscesses.
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