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Osteomyelitis with a twist: Streptococcus pneumoniae causing sternoclavicular septic arthritis.

Murthy R, Petrescu D, Salit IE - Can J Infect Dis Med Microbiol (2015 Sep-Oct)

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, The University of Ottawa, Ottawa;

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An 80-year-old woman of Caribbean descent with a history of type 2 diabetes mellitus, gout, osteoarthritis, gastrointestinal reflux and atrial fibrillation, presented with a 12 h history of left-sided shoulder, neck and back pain... Blood cultures were positive in three of three sets for penicillin-susceptible Streptococcus pneumoniae... Aspiration of the sternoclavicular joint (SCJ) was unsuccessful... Transesophageal echocardiography did not reveal evidence of endocarditis... The chest radiograph did not reveal evidence of pneumonia... Due to its relative rarity as a causative pathogen, culture positivity for S pneumoniae should prompt further investigation into other risk factors, such as concomitant pneumonia or infective endocarditis, leading to bacteremia... In a review of 180 cases of septic arthritis of the SCJ, risk factors included intravenous drug use (IVDU) (21%), a distant site of infection (15%), diabetes mellitus (13%), trauma (12%) and an infected central venous line (9%)... S pneumoniae is an unusual cause of septic arthritis... In the present case it caused SCJ septic arthritis and osteomyelitis, resulting in the patient’s presentation with fever, pain and torticollis... Important considerations include early initiation of appropriate empirical antibiotic therapy, and identification of precipitants, risk factors and/or potential complications, such as osteomyelitis or mediastinitis that may require longer treatment duration or surgical intervention... The present case highlights the significant morbidity of SCJ infection, even in the absence of such complications.

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Related in: MedlinePlus

Left: physical examination findings of edema, erythema and torticollis; right: corresponding magnetic resonance image displaying soft tissue and manubrium signal uptake, as well as joint space effusion
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f1-cjidmm-26-251: Left: physical examination findings of edema, erythema and torticollis; right: corresponding magnetic resonance image displaying soft tissue and manubrium signal uptake, as well as joint space effusion


Osteomyelitis with a twist: Streptococcus pneumoniae causing sternoclavicular septic arthritis.

Murthy R, Petrescu D, Salit IE - Can J Infect Dis Med Microbiol (2015 Sep-Oct)

Left: physical examination findings of edema, erythema and torticollis; right: corresponding magnetic resonance image displaying soft tissue and manubrium signal uptake, as well as joint space effusion
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4644007&req=5

f1-cjidmm-26-251: Left: physical examination findings of edema, erythema and torticollis; right: corresponding magnetic resonance image displaying soft tissue and manubrium signal uptake, as well as joint space effusion

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, The University of Ottawa, Ottawa;

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

An 80-year-old woman of Caribbean descent with a history of type 2 diabetes mellitus, gout, osteoarthritis, gastrointestinal reflux and atrial fibrillation, presented with a 12 h history of left-sided shoulder, neck and back pain... Blood cultures were positive in three of three sets for penicillin-susceptible Streptococcus pneumoniae... Aspiration of the sternoclavicular joint (SCJ) was unsuccessful... Transesophageal echocardiography did not reveal evidence of endocarditis... The chest radiograph did not reveal evidence of pneumonia... Due to its relative rarity as a causative pathogen, culture positivity for S pneumoniae should prompt further investigation into other risk factors, such as concomitant pneumonia or infective endocarditis, leading to bacteremia... In a review of 180 cases of septic arthritis of the SCJ, risk factors included intravenous drug use (IVDU) (21%), a distant site of infection (15%), diabetes mellitus (13%), trauma (12%) and an infected central venous line (9%)... S pneumoniae is an unusual cause of septic arthritis... In the present case it caused SCJ septic arthritis and osteomyelitis, resulting in the patient’s presentation with fever, pain and torticollis... Important considerations include early initiation of appropriate empirical antibiotic therapy, and identification of precipitants, risk factors and/or potential complications, such as osteomyelitis or mediastinitis that may require longer treatment duration or surgical intervention... The present case highlights the significant morbidity of SCJ infection, even in the absence of such complications.

No MeSH data available.


Related in: MedlinePlus