日本未熟児新生児学会雑誌　第26巻第1号　67～70頁（2014年）

日本未熟児新生児学会雑誌　26(1)：67-70；2014　

受付日：平成24．12．12

受理日：平成25．06．05

鎖骨骨髄炎の一新生児例

Neonate with Osteomyelitis of the Clavicle

＊1昭和大学　医学部　小児科学講座，＊2東京都保健医療公社荏原病院　小児科，＊3町田市民病院　小児科

＊1Department of Pediatrics, Showa University School of Medicine，＊2Department of Pediatrics, Tokyo Metropolitan Health and Medical Treatment Corporation Ebara Hospital，＊3Department of Pediatrics, Machida Municipal Hospital

松橋一彦＊1・阿部祥英＊1・櫻井俊輔＊2・佐藤祐子＊3・山口克彦＊3・佐藤　裕＊3

Kazuhiko MATSUHASHI＊1，Yoshifusa ABE＊1，Shunsuke SAKURAI＊2， Yuko SATO＊3，Katsuhiko YAMAGUCHI＊3，Yutaka SATO＊3

Key Words：osteomyelitis，neonate，clavicle，MRI

　新生児期の日齢26に発症した右鎖骨骨髄炎の一女児例を経験したので報告する。妊娠分娩歴に異常はなく，分娩時外傷は認めなかった。入院前日から発熱が出現し，新生児の発熱のため，当院を紹介されて入院した。入院時，右肩周囲に軽度腫脹を認めた。画像検査では右鎖骨や上腕骨に異常は認めなかったが，臨床症状から骨髄炎を否定できず，経過中の画像検査から右鎖骨骨髄炎と最終診断した。原因菌は特定できなかったが，セフメタゾールナトリウム（CMZ）と硫酸アミカシン（AMK）の経静脈投与，塩酸セフカペンピボキシル（CFPN-PI）の内服による治療で改善した。治療から4 年が経過した現在でも後遺症は認めていない。

　We here report the case of a 26-day-old female neonate with osteomyelitis of the right clavicle. The pregnancy and delivery were normal. Birth trauma was not proved. She was referred and admitted to our hospital because of fever, which she had on the day before admission. On admission, mild swelling was observed on the right shoulder joint. The initial imaging examination revealed no abnormal findings of the right clavicle or humerus, but clinical findings indicated that osteomyelitis could not be ruled out. The infant was diagnosed as having osteomyelitis of the right clavicle on the basis of an imaging examination performed during her hospitalization. Although the pathogen causing osteomyelitis was not determined, her symptoms improved following treatment with cefmetazole at 140mg/kg bodyweight/day, amikacin at 5.5mg/kg bodyweight/day, and cefcapene pivoxil. Four years to date since her treatment, the patient has remained in good health and shows no sequelae of osteomyelitis.