Korean J Thorac Cardiovasc Surg.  2009 Apr;42(2):220-225.

The Clinical Results of Surgical Treatment for Sternoclavicualr Septic Arthritis

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Korea.
  • 2Department of Thoracic and Cardiovascular Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Korea. lheecs@naver.com
  • 3Department of Thoracic and Cardiovascular Surgery, Kangdong Saced Heart Hospital, Hallym University College of Medicine, Korea.
  • 4Department of Thoracic and Cardiovascular Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Korea.
  • 5Department of Thoracic and Cardiovascular Surgery, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Korea.
  • 6Department of Thoracic and Cardiovascular Surgery, Hallym University College of Medicine, Korea.

Abstract

BACKGROUND
Sternoclavicular septic arthritis manifests serious complications such as abscess, osteomyelitis, mediastinitis and empyema; therefore, a prompt diagnosis and appropriate treatment are necessary. MATERIAL AND METHOD: The treatment results of eight patients with sternoclavicular septic arthritis and who had been surgically treated at our institutions between September 2005 and July 2008 were retrospectively reviewed. The surgical treatment they underwent was en bloc resection, including partial resection of the sternum, the clavicular head and the 1st rib. RESULT: The patients ranged in age from 40 to 74 years with an average of 55.1+/-10.3 years. Five were men and three were women. There were 6 patients with spontaneous sternoclavicular septic arthritis and 2 patients had their condition induced by central venous catheters. The pathogens isolated from the patients' blood and wounds were MRSA (3), Streptococcus intermedius (1), Streptococcus agalactiae (1) and Pseudomonas luteola (1). One patient expired from aggravation of preoperative sepsis on POD 31.
CONCLUSION
The life-threatening complications from sternoclavicular septic arthritis can progress and lead to death unless appropriate treatment is administered. A prompt diagnosis, appropriate antibiotics therapy and effective surgical treatment such as radical en bloc resection can reduce the morbidity and mortality of this malady.

Keyword

Infection; Treatment outcome; Sternoclavicular joint; Septocemia

MeSH Terms

Abscess
Anti-Bacterial Agents
Arthritis, Infectious
Central Venous Catheters
Female
Head
Humans
Male
Mediastinitis
Methicillin-Resistant Staphylococcus aureus
Osteomyelitis
Pseudomonas
Retrospective Studies
Ribs
Sepsis
Sternoclavicular Joint
Sternum
Streptococcus agalactiae
Streptococcus intermedius
Treatment Outcome
Anti-Bacterial Agents
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