Hyperbaric Oxygenation Therapy as Adjunctive Treatment of Complex Wound Associated with Sterno-clavicular Septic Arthritis.

Abstract

Introduction: Sternoclavicular septic arthritis with pyomyositis is a relatively rare condition. While most cases of septic arthritis are caused by gram-positive organisms, such as Staphylococci and Streptococci spp., a small number of patients present with gram-negative organisms as the cause of their condition. Signs and symptoms can be non-specific, and although CT imaging aids in diagnosis, a timely identification relies primarily on a high index of clinical suspicion.

Case description: We present a case of a 44-year-old female patient with a history of poorly controlled diabetes mellitus who presented with a chronic, non-healing wound that developed on a background of non-traumatic sternoclavicular septic arthritis, chronic osteomyelitis of the clavicle and manubrium, and concomitant pectoralis pyomyositis caused by a gram-negative pathogen. The use of HBO₂ as an addition to this patient's treatment regimen hastened the healing process.

Conclusion: Given the rarity of this condition, we consider that adding to the body of literature with regards to the diagnosis and treatment of this condition can help clinicians develop a keen eye for it, decreasing the morbidity and mortality associated with it.