Chronic Osteomyelitis of Clavicle in a Neonate: Report of Morbid Complication of Adjoining MRSA Abscess

Abstract

Osteomyelitis of clavicle is rare in neonates. Acute osteomyelitis of clavicle accounts for less than 3% of all osteomyelitis cases. It may occur due to contiguous spread, due to hematogenous spread, or secondary to subclavian catheterization. Chronic osteomyelitis may occur as a complication of residual adjoining abscess due to methicillin resistant staphylococcus aureus (MRSA) sepsis. We report a newborn female with right shoulder abscess that developed chronic clavicular osteomyelitis in follow-up period after drainage. She required multiple drainage procedures and was later successfully managed with bone curettage and debridement. We report this case to highlight that a MRSA abscess may recur due to residual infection from a chronic osteomyelitis sinus. It may be misdiagnosed as hypergranulation tissue of nonhealing wound leading to inappropriate delay in treatment. High index of suspicion, aggressive initial management, and regular follow-up are imperative to prevent this morbid complication.

A Rare Complication in a Child with Sickle Cell Anemia: Clavicular Osteomyelitis

“…Nonetheless, the gold standard in the diagnosis of osteomyelitis and its complications is MRI. It serves an advantage especially in the evaluation of the soft tissue (11). Though direct graphy did not determine osteomyelitis in our patient, MRI confirmed the diagnosis.…”

Orak Hücreli Anemili Bir Çocukta Nadir Bir Komplikasyon: Klaviküler Osteomiyelit

“…Ancak osteomiyelitin ve komplikasyonlarının tanısında altın standart MRG'dir. Özellikle yumuşak dokunun değerlendirilmesi için avantaj sağlamaktadır (11). Biz de direkt grafi ile hastamızda osteomiyelit tespit edemediğimiz halde, MRG ile tanıyı doğruladık.…”

Clinical analysis of 17 cases of neonatal osteomyelitis

“…Depending on the neonatal osteomyelitis pathogen, if neonatal osteomyelitis is suspected, combined antibiotic therapy for Staphylococcus and Gram-negative bacteria is recommended, while oxacillin or vancomycin are recommended for use against methicillin-resistant S aureus (MRSA). [19] Castellazzi et al [8] suggested that empirical treatment for neonatal osteomyelitis should include oxacillin with the addition of gentamicin.…”