Park A, Lehnerdt G, Lautermann J
Universitäts-Hals-Nasen-Ohren-Klinik, Universität Duisberg-Essen, Hufelandstrasse 55, 45122 Essen.
Laryngorhinootologie. 2007 Feb;86(2):124-7. doi: 10.1055/s-2006-925205. Epub 2006 Apr 10.
This article describes a rare case of a myositis of the sternocleidomastoid muscle due to an acute septic arthritis of the sternoclavicular joint. A 51-year-old male in reduced condition was admitted to the Department of Otorhinolaryngology with a one-week history of a painless swelling of the sternocleidomastoid muscle associated with recurrent fever. Physical examination was otherwise unremarkable. An intravenous antibiotic therapy was initiated without improvement of the process, accordingly a specific infection or a malignancy was ruled out by biopsy. The positron emission tomography and magnetic resonance imaging finally revealed the diagnosis of a septic arthritis of the sternoclavicular joint as the causal focus of the infection. After an extensive surgical debridement and under continued antibiotic therapy the patient made an uneventful recovery. The acute septic arthritis of the sternoclavicular joint is an uncommon infection with an insidious onset and is often unrecognized until it spreads to adjacent structures leading to serious complications. This case emphasizes that a myositis of sternocleidomastoid muscle can be caused by an ascending infection due to an acute septic arthritis of the sternoclavicular joint. Clinical course, diagnosis and treatment of this uncommon disease are reviewed in this article.
本文描述了一例罕见的因胸锁关节急性化脓性关节炎导致胸锁乳突肌肌炎的病例。一名身体状况欠佳的51岁男性因胸锁乳突肌无痛性肿胀伴反复发热一周入住耳鼻喉科。体格检查未见其他异常。开始静脉应用抗生素治疗,但病情无改善,因此通过活检排除了特定感染或恶性肿瘤。正电子发射断层扫描和磁共振成像最终揭示胸锁关节化脓性关节炎是感染的病因。经过广泛的手术清创并持续使用抗生素治疗后,患者顺利康复。胸锁关节急性化脓性关节炎是一种罕见的感染,起病隐匿,在扩散至邻近结构导致严重并发症之前常未被识别。本病例强调胸锁乳突肌肌炎可由胸锁关节急性化脓性关节炎的上行性感染引起。本文对这种罕见疾病的临床病程、诊断和治疗进行了综述。