American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: Editor-in-chief: Apply for this position
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American Journal of Medical Case Reports. 2021, 9(5), 281-285
DOI: 10.12691/ajmcr-9-5-5
Open AccessArticle

Sternoclavicular Joint Abscess Necessitating Empyema: Four ED Visits in Six Days

Ahmed Hashim1, , Raai Mahmood1, Mohamedanwar Ghandour2, Hammam Shereef1, Ammar ELJack3, Cecilia Big4, Kevin Jamil5 and Rajiv John1

1Department of Internal Medicine, Beaumont Health- Dearborn, MI, USA

2Division of Nephrology, Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, MI, USA

3Division of Cardiology, Department of Internal Medicine, Baylor- Scott/white heart hospital, Plano, Tx, USA

4Division of Infectious Diseases, Department of Internal Medicine, Beaumont Health- Dearborn, MI, USA

5Division of Thoracic Surgery, Beaumont Health- Dearborn, MI, USA

Pub. Date: February 24, 2021

Cite this paper:
Ahmed Hashim, Raai Mahmood, Mohamedanwar Ghandour, Hammam Shereef, Ammar ELJack, Cecilia Big, Kevin Jamil and Rajiv John. Sternoclavicular Joint Abscess Necessitating Empyema: Four ED Visits in Six Days. American Journal of Medical Case Reports. 2021; 9(5):281-285. doi: 10.12691/ajmcr-9-5-5


We report a case of Sternoclavicular Joint (SCJ) infection in a 52-year-old male who developed an empyema over six days. During the first three visits, he had worsening pectoral and shoulder pain and was symptomatically treated and discharged. During the first ED visit, a computed tomography (CT) scan of the neck was negative. During the second ED visit, CTA chest was negative for pulmonary embolism. Three days later, CTA of the neck showed density from the left first rib to the left sternoclavicular joint, suggesting a hematoma. During the final ED visit, CT of the chest showed a left anterior chest wall abscess contiguous with a left upper lobe empyema. VATS confirmed empyema and revealed costochondral and SCJ abscess. Decortication, SCJ resection, and pectoralis muscle debridement were performed. Methicillin-susceptible Staphylococcus Aureus (MSSA) was isolated from surgical cultures. After the pectoralis muscle flap closure, he was treated with IV cefazolin for a total of six weeks. Health care professionals should have a high index of suspicion for SCJ infections in patients with a similar clinical presentation. This case highlights the importance of early and prompt diagnosis of MSSA SCJ infections to prevent sequelae of the disease.

sternoclavicular joint video-assisted thoracoscopic surgery decortication

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