DOI: 10.36347/sjmcr.2018.v06i09.030

Pages: 715-716

A 65-year-old woman was admitted to a local hospital for the treatment of bacterial knee arthritis after undergoing total knee prosthesis three months prior to being admitted to our hospital. Her past history included rheumatoid arthritis, diabetes mellitus, left calcaneus fracture and left femoral neck fracture requiring operation. She had been discharged after the improvement of the infection without antibiotics three weeks prior to being admitted to our hospital. However, she noticed left sternoclavicular joint pain one week prior to being admitted to our hospital and was re-admitted the local hospital due to signs of infection at the left sternoclavicular joint. Puncture at the joint confirmed the presence of pus. She was treated with antibiotics but her circulation and consciousness deteriorated, and she was transported to our department. Chest computed tomography depicted fluid collection with ring enhancement at just in front of and behind the left sternoclavicular joint. She received fluid resuscitation, a cefazoline infusion, and urgent aggressive open abscess drainage. After these treatments, her consciousness and unstable circulation dramatically improved and she became able to feed herself. Sternoclavicular pyoarthritis is rare disease for which a prompt diagnosis and treatment are required to obtain a favorable outcome.