Sternal osteomyelitis is extremely rare in neonates. We present the first report of a neonate with primary sternal osteomyelitis and an extensive mediastinal collection. Magnetic resonance imaging was used to delineate the extent of bony and soft tissue involvement. Serial ultrasound imaging proved useful for monitoring the response to treatment. The patient was successfully treated with antibiotics, surgical débridement, vacuum-assisted dressings, and delayed primary closure.
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