title: Chronic Osteomyelitis of Clavicle in a Neonate: Report of Morbid Complication of Adjoining MRSA Abscess.
abstract: Osteomyelitis of clavicle is rare in neonates. Acute osteomyelitis of clavicle accounts for less than 3% of all osteomyelitis cases. It may occur due to contiguous spread, due to hematogenous spread, or secondary to subclavian catheterization. Chronic osteomyelitis may occur as a complication of residual adjoining abscess due to methicillin resistant staphylococcus aureus (MRSA) sepsis. We report a newborn female with right shoulder abscess that developed chronic clavicular osteomyelitis in follow-up period after drainage. She required multiple drainage procedures and was later successfully managed with bone curettage and debridement. We report this case to highlight that a MRSA abscess may recur due to residual infection from a chronic osteomyelitis sinus. It may be misdiagnosed as hypergranulation tissue of nonhealing wound leading to inappropriate delay in treatment. High index of suspicion, aggressive initial management, and regular follow-up are imperative to prevent this morbid complication.
authors.affiliation: Department of Orthopaedics, Pondicherry Institute of Medical Sciences, Pondicherry 605014, India.
authors.forename: Shishir Murugharaj
authors.initials: SM
authors.lastname: Suranigi
authors.affiliation: Department of Pediatric Surgery, Pondicherry Institute of Medical Sciences, Pondicherry 605014, India.
authors.forename: Manoj
authors.identifier: 0000-0003-4551-8279
authors.initials: M
authors.lastname: Joshi
authors.affiliation: Department of Orthopaedics, Pondicherry Institute of Medical Sciences, Pondicherry 605014, India.
authors.forename: Pascal Noel
authors.initials: PN
authors.lastname: Deniese
authors.affiliation: Department of Orthopaedics, Pondicherry Institute of Medical Sciences, Pondicherry 605014, India.
authors.forename: Kanagasabai
authors.initials: K
authors.lastname: Rangasamy
authors.affiliation: Department of Orthopaedics, Pondicherry Institute of Medical Sciences, Pondicherry 605014, India.
authors.forename: Syed
authors.initials: S
authors.lastname: Najimudeen
authors.affiliation: Department of Orthopaedics, Pondicherry Institute of Medical Sciences, Pondicherry 605014, India.
authors.forename: James J
authors.initials: JJ
authors.lastname: Gnanadoss