Newborn with Primary Sternal Osteomyelitis and Systemic Sepsis Caused by X-linked Hereditary Congenital Neutropenia: A Case Report and Literature Review

Khalil AH , Elfiky Mand Schellerer VS

Department of Pediatric Surgery, University Medicine Greifswald, Germany Department of Pediatric Surgery, Cairo University, Egypt Department of Pediatric Surgery and Pediatric Urology, Klinikum Braunschweig gGmbH, Germany

^*Correspondance to: Mahmoud Elfiky 

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Abstract:

Introduction: We present a rare case of neonatal primary sternal osteomyelitis caused by a congenital be X-linked neutropenia. Case Report: The baby was admitted for the first time at the age of 6 days with neonatal sepsis which recurred after few days along a subcutaneous pre-sternal abscess. After surgical drainage and debridement, the recovery was uneventful. The baby received 4 G-CSF (Granulocyte Colony-Stimulating Factor) doses in addition to the IV antibiotics according to the microbiological investigations of the abscess material showing Staphylococcus aureus (MSSA). Histologically, a severe purulent florid osteomyelitis of the sternum. Follow up with MRI showed small residual infection of the original osteomyelitis with low bone edema, that was sufficiently treated with another IV antibiotic until full resolution of the inflammation. Genetic analysis was carried out to reveal mutation in the WAS gene. According to protocol, the neonate was sent to the European Working Group of MDS and SAA in children (EWOG-MDS/ SAA) for follow up. Conclusion: X-linked hereditary congenital severe neutropenia should be suspected in neonatal sepsis with the corresponding inflammatory and laboratory parameters. Surgical intervention is adequate but has to follow complete medical diagnosis and protocols.

Keywords:

Osteomyelitis; Sepsis; Neutropenia: MSSA

Cite the Article:

Khalil AH, Elfiky M, Schellerer VS. Newborn with Primary Sternal Osteomyelitis and Systemic Sepsis Caused by X-linked Hereditary Congenital Neutropenia: A Case Report and Literature Review. World J Surg Surgical Res. 2023; 6: 1459..