A Rare Case of Clavicle Osteomyelitis in a Child and Literature Review
Table 1
Cases of acute clavicle osteomyelitis.
Number
First author/Publication year
Age
Gender
Symptoms & signs
Side
Isolate
Treatment
Outcome
1
Morrey/1977
2 wks
M
Painful swelling
Right
Hemolytic Streptococcus
IV penicillin 300,000 U × 210 days initially and then (due to abscess) IV penicillin 300,000 U × 6 for 2.5 weeks
Abscesses of right clavicle were incised and drained. IV penicillin 300,000 U × 6 for 2.5 wks, during which the patient became asymptomatic. 16 yrs later no recurrence
2
Morrey/1977
16 yrs
M
Pain and swelling
Right
S. aureus
Parenteral penicillin 500 mg × 4 for 17 d (due to drainage from the wound) Erythromycin (orally) 500 mg × 4 for 2 wks
One month after the abscess was drained, the patient was referred because of persistent drainage from the wound The patient was placed on erythromycin and the wound ceased draining during 2 weeks No recurrence after 9 yrs
3
Donovan/1982
12 yrs
F
Pain, swelling
Left
No growth
8-weak antibiotics
NR
4
Donovan/1982
10 yrs
F
Pain
Left
Not cultured
Antibiotics
Recurrence after an interval of over a year, then antibiotics
5
Donovan/1982
9 yrs
F
Pain
Left
No growth
3-month antibiotics
The swelling persisted after 6 months; radiographs revealed further expansion with a well-organised periosteal reaction; final diagnosis was acute to chronic osteomyelitis; following curettage, the localised swelling at the medial end of the clavicle has subsided-disease-free
6
Franklin/1987
15 yrs
M
Pain
Left
NR
Empiric antibiotic therapy
NR
7
Franklin/1987
3 yrs
F
Pain
Left
NR
Empiric antibiotic therapy
NR
8
Franklin/1987
9 yrs
F
Pain
Right
NR
Empiric antibiotic therapy
NR
9
Franklin/1987
9 yrs
F
Pain
Right
NR
Empiric antibiotic therapy
NR
10
Gerscovich/1994
7 yrs
F
2-month pain & fever
Right
S. aureus
NR
NR
11
Gerscovich/1994
11 yrs
F
2-weak pain & fever
Right
S. aureus
NR
NR
12
Gerscovich/1994
13 yrs
F
6-weak pain
Right
No growth
NR
NR
13
Gerscovich/1994
16 yrs
M
3-weak pain & fever
Left
Not cultured
NR
NR
14
Lowden/1997
7 yrs
M
4-day pain
Right
S. aureus
3-weak IV antibiotics + 3-weak oral antibiotics
6 weak after discharge pathologic fracture of right clavicle; 5 months after initial presentation, resorption of segment of clavicle
15
Lowden/1997
8 yrs
M
Pain & fever
Left
S. aureus
3-weak IV flucloxacillin + 4-weak oral flucloxacillin
No recurrence at 1 year
16
Our case
12 yrs
M
Pain, fever
Right
S. aureus
3-day IV vancomycin & cefotaxime 3-weak IV clindamycin & 3-weak oral clindamycin
No recurrence
NR: not reported Only 2 of 16 cases of acute and chronic osteomyelitis reported had positive cultures Surgery was required in 2 of 16 cases of osteomyelitis. Otherwise, outcome is favourable.
