A Case of Osteomyelitis of the Clavicle as a Complication of Subclavian Vein Catheterization in Hemodialysis Patient

Korean Journal of Nephrology 2008;27(5):594-599.

Chul-yun Park, M.D., Kyung Ryun Bae, M.D., Seung-woon Jun, M.D., Jin-ho Kwak, M.D., In Hee Lee, M.D. and Ki Sung Ahn, M.D.

Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea

증례 : 혈액투석 환자에서 쇄골하정맥 도관 삽입 후 쇄골에 발생한 골수염 1예

박철연, 배경륜, 전승운, 곽진호, 이인희, 안기성

대구가톨릭대학교 의과대학 내과학교실

Abstract

Osteomyelitis (OM) of the clavicle is a rare complication of the central venous catheterization and has been reported infrequently in the literature. We report here a case of OM of the left clavicle complicating right subclavian vein catheterization performed for hemodialysis (HD). A 41-year-old male patient on HD for 3 months complained of pain and mass over the left sternoclavicular joint. Computerized tomography showed a demarcated soft tissue mass. Bone scan demonstrated increased tracer uptake in the left clavicle compatible with OM. The patient underwent surgical exploration with removal of the necrotic bone and he was treated with antibiotics including vancomycin. Afterward he remained well on HD. In conclusion, OM should be considered in any dialysis patient who develops pain and signs of inflammation in the sternoclavicular area after central venous catheterization for HD.

Key Words: Osteomyelitis, Catheterization, Central venous, Hemodialysis