胸鎖関節炎に合併した胸鎖乳突筋内膿瘍，縦隔膿瘍例

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  • A Case of Sternocleidomastoid Pyomyositis and Mediastinal Abscess with Sternoclavicular Septic Arthritis

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<p>We report a case of sternocleidomastoid muscle and mediastinal abscesses developing as a complication of sternoclavicular joint arthritis, along with a brief review of the literature. A 67-year-old man presented to us with a history of left shoulder pain and neck pain. CT showed a large heterogeneous mass occupying the left sternocleidomastoid muscle, with a high-density area around the sternoclavicular joint. We performed drainage of the sternocleidomastoid muscle and anterior chest wall abscesses, and a tracheostomy. The patient was also diagnosed as having sepsis and received broad-spectrum antibiotic therapy. Cultures from both the neck abscess and blood grew Staphylococcus aureus. The abscess spread to the middle mediastinum by day 7 of hospitalization. Because of the neck and mediastinal abscesses, operation was performed a third time, along with antibiotic therapy. The purulent arthritis was treated conservatively. One month after the operation, the patient resumed oral intake, and after two months, he was discharged home. Herein, we report a case in which sternoclavicular joint arthritis was complicated by the formation of an abscess in the sternocleidomastoid muscle and a mediastinal abscess. Depending on individual cases, appropriate treatment may require multidisciplinary cooperation.</p>

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