Bilateral clavicle osteomyelitis: A case report

Abstract

INTRODUCTIONOsteomyelitis of the clavicle is rare. Infection occurs from hematogenous spread or trauma. In adults infection is usually secondary due to an exogenous cause such as open fractures, surgery (iatrogenic) or spread from local tissue with infection.PRESENTATION OF CASEThe case is presented here of a 50-year old female with bilateral clavicular fractures, who was operated on with open reduction and internal fixation. At the 6-month follow-up, she had complaints of bilateral osteomyelitis which was successfully treated with resection of the infected segment of the bone, and antibiotic impregnated collagen.DISCUSSIONPredisposing factors include diabetes, intravenous drug abuse, tuberculosis or immune suppression. Management involves the removal of bone fixation, debridement of the bone and if there is a defect, coverage with a muscle flap is applied.CONCLUSIONIn cases of clavicular osteomyelitis where infection continues despite debridement and antibiotic therapy, excision of the sequestered clavicular section is a successful treatment approach and has been seen to improve quality of life without any functional loss.

Difficult clinical management of antituberculosis DRESS syndrome complicated by MRSA infection

“…Clavicular osteomyelitis is a rare clinical entity and can occur as a complication of subclavian vein catheterization and neck surgery. [18] MRSA is known to be endemic in hospital settings across the world and accounts for 40% to 60% of all nosocomial Staphylococcus aureus infections. Additionally, systemic causes such as use of corticosteroids, intravenous drug abuse, tuberculosis, diabetes, and cancers, can predispose to infectious complications.…”

Unilateral Osteomyelitis of the Clavicle in Childhood:A Case Report

“…The incidence in males is more than that in females and patients have chest (78%) and shoulder pain (24%) respectively. [1][2][3] In adults, factors such as intravenous drug use (21%), a distant site infection (15%), diabetes mellitus (13%), trauma, subclavian venous catheterization, and rheumatoid diseases can develop infection of the clavicle, 3,5,6 but in 23% of the case reports, there is no risk factor. 5,7 Everyone must exclude diagnoses such as chronic recurrent multifocal osteomyelitis, neoplasia, rheumatoid arthritis, and chronic multifocal periosteitis.…”

“…In adults, osteomyelitis of clavicle is secondary to open fractures, surgery or neighborhood infective tissue. [1][2][3] We report a case of a 4-year old boy without any previous underlying disorder. Magnetic resonance imaging (MRI) images showed infection of the clavicle in the lateral 1/3 of the bone.…”

Tubercular osteomyelitis of the lateral-third of the clavicle

“…Skeletal tubercular lesions can be haematogenous, or due to trauma or local extension of infected tissue. The usual source in adults is from iatrogenic trauma (surgery) or open fractures 6 7. If the spread is haematogenous, the primary focus may be active or quiescent in a pulmonary or extra-pulmonary site.…”