Question:

A 37-year-old female presents to the ER with right, upper back pain. She has a history of trauma two months prior where she was impailed in her right chest with a tire rod while driving. At the time of injury, she sustained a right comminuted clavicular fracture, which required ORIF by orthopedic surgery. She states she has tenderness at her surgical site, swelling of her right upper back and subjective fevers at home. What does her chest CT show?

Answer:

Her chest CT shows the development of a large, multiloculated complex collection involving the right posterior chest wall and right lung apex, including a posterior subcutaneous component extending to the skin, highly concerning for an abscess. Orthopedic surgery was again consulted. The patient required multiple surgical debridements for a right subclavicular and supraclavicular abscess and chest wall abscess. She was placed on IV antibiotics and had a protracted hospital course.