Fever, pain, erythema, edema, and purulent drainage are often present when early infections are caused by pyogenic organisms such as S. aureus , streptococci, or enteric gram-negative bacilli. When early infections are caused by less pathogenic organisms, such as S. epidermidis or diphtheroids, the disease presents more insidiously. Chronic contiguous infections are usually diagnosed 6 to 24 months after surgery. The patient usually presents with persistent pain. Most infections are probably introduced during surgery but remain quiescent for a long time.
Patients have fever, a slightly erythematous wound, and persistent pain.
Frequent pathogens include S. epidermidis , S. aureus , and gram-negative bacilli. The presence of sternal wires, used to approximate the sternum, is a major risk factor for development of chronic recurrent osteomyelitis. Surgical removal of the wires is essential for recovery. Mortality may be high in complicated cases.