Septic Arthritis of the Sternoclavicular Joint Complicated by Empyema and Bronchopleural Fistula: A Case Report

Septic arthritis of the sternoclavicular joint is a rare infectious arthritis in which the risk factors are reported to be such as diabetes, immunosuppression, and intravenous drug use. Due to a lack of prominent symptoms, delayed diagnosis can lead to severe complications such as mediastinitis and empyema. Advanced sternoclavicular septic arthritis can be a hidden etiology masked by severe symptoms. Therefore, awareness of this condition is crucial for timely and appropriate treatment. We report a rare case of sternoclavicular septic arthritis progressing to empyema with bronchial fistulae. The patient was successfully treated with multidisciplinary interventions, including endoscopic bronchial occlusion, open-window thoracostomy, negative-pressure wound therapy, sternoclavicular joint debridement, and reconstruction with a contralateral pectoralis major flap. This report discussed the treatment strategy with a review of the previous literature.