Streptococcus pyogenes Sternoclavicular Septic Arthritis in a Healthy Adult

Savcic-Kos, Radmila M.; Mali, Padmavati; Abraham, Ajit; Issa, Meltiady; Rangu, Venu; Nasser, Rana M.

doi:10.3121/cmr.2013.1185

Cited by 6 publications

(8 citation statements)

References 18 publications

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“… 7 , 10 , 11 In our review of the literature, we found numerous reported cases of S. pyogenes causing sternoclavicular septic arthritis in an immunocompromised adult patient or IV drug abusers; however, there has been only one reported case of in an immunocompetent adult patient. 1 , 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

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Sternoclavicular Septic Arthritis Caused by Streptococcus pyogenes in a Child

Paez-Perez

McGovern

Flannery

et al. 2017

CPC-EM

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Septic arthritis can be a devastating condition that leads to further morbidity and potential mortality if not identified early in its course. Emergency providers must keep septic arthritis high on their differential of any joint-related pain in the pediatric population. We present a case of an eight-year-old female who initially presented with the chief complaint of chest pain and was subsequently diagnosed with septic arthritis of the left sternoclavicular joint in the emergency department.

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Section: Discussionmentioning

confidence: 99%

“…Clindamycin or vancomycin are adequate first line anti-staphylococcal agents in an otherwise-healthy patient. 13 In patients with immunosuppression or concurrent peripheral infection, antibiotics that target Gram-negative bacteria should also be included.…”

Section: Discussionmentioning

confidence: 99%

Sternoclavicular Septic Arthritis Caused by Streptococcus pyogenes in a Child

Paez-Perez

McGovern

Flannery

et al. 2017

CPC-EM

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“…The synovial fluid culture in this case was positive for GAS. Another case described septic arthritis in the sternoclavicular joint (SCJ) in a 62-year old healthy man [12]. He initially presented with fatigue and cough for 3 weeks with a history of exposure to documented GAS pharyngitis from his children.…”

Section: Discussionmentioning

confidence: 99%

Septic Arthritis of the Knee and Necrotizing Fasciitis in a Young Immunocompetent Adult: A Case Report

Miptah¹,

Badlishah-Sham²,

LLyod³

et al. 2018

JCHS

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Septic arthritis is uncommon in immunocompetent young adults. It typically presents in individuals with underlying risk factors. Isolation of Group A Streptococcus (GAS) as the causative agent of septic arthritis is usually associated with autoimmune diseases, chronic skin infections or trauma. Here we report a case of a young lady who is immunocompetent without any prior history of trauma, who presented with an abrupt onset of left knee pain and swelling to the emergency department. An initial diagnosis of acute gout was made and she was treated with non-steroidal anti-inflammatory drug (NSAID). She presented again two days later to a primary care clinic with worsening knee pain and severe left calf pain. A clinical diagnosis of septic arthritis was suspected and the patient was urgently referred to the Orthopaedic team. Synovial fluid from the knee joint aspiration showed growth of GAS. A diagnosis of necrotizing fasciitis was also made as the culture taken from the left calf during incision and drainage (I&D) procedure showed a mixed growth. She eventually underwent surgical debridement twice, together with the administration of several courses of intravenous antibiotics leading to her full recovery after 45 days. This case demonstrates the challenge in making a prompt diagnosis of septic arthritis and probable Type II necrotizing fasciitis in an immunocompetent adult without underlying risk factors. Any delay in diagnosis and treatment would have increased the risk of damage to her knee joint and this may be fatal even in a previously healthy young adult. KEYWORDS: septic arthritis, immunocompetent, Group A streptococcus, necrotizing fasciitis

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“…Staphylococcus aureus is the most common causative pathogen among culture-proven cases of SCJ septic arthritis (49%), followed by Pseudomonas aeruginosa (10%), Brucella melitensis (7%), and Escherichia coli (5%). [ 3 , 5 ] Other causative pathogens such as group B streptococcus, Mycobacterium tuberculosis , Streptococcus pneumoniae , and polymicrobial bacteria have also been reported. [ 5 , 6 ] A rapid diagnosis of SCJ septic arthritis by imaging studies is important, as this condition could lead to serious complications such as osteomyelitis (55%), chest wall abscess or phlegmon (25%), and mediastinitis (13%).…”

Section: Introductionmentioning

confidence: 99%

“…[ 3 , 5 ] Other causative pathogens such as group B streptococcus, Mycobacterium tuberculosis , Streptococcus pneumoniae , and polymicrobial bacteria have also been reported. [ 5 , 6 ] A rapid diagnosis of SCJ septic arthritis by imaging studies is important, as this condition could lead to serious complications such as osteomyelitis (55%), chest wall abscess or phlegmon (25%), and mediastinitis (13%). [ 1 , 6 – 8 ] After the diagnosis of SCJ arthritis is established, surgical treatment with en-bloc resection of the SCJ and ipsilateral pectoralis major muscle flap is preferred in the definitive treatment approach.…”

Section: Introductionmentioning

confidence: 99%

Medical management of septic arthritis of sternoclavicular joint

Kwon

Cha

et al. 2020

Medicine

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Rationale: Sternoclavicular joint septic arthritis is an unusual disease in healthy adults, and Staphylococcus aureus is the most common causative pathogen. The current treatment of choice is surgery with sternoclavicular joint resection and pectoralis flap closure, especially when the disease is complicated by osteomyelitis and abscess. Patient concerns: Here, we report a 76-year-old woman without risk factors who visited our hospital for pain and redness, swelling on the left anterior chest wall. Diagnosis: Magnetic resonance imaging showed infectious arthritis in the left SCJ, with multiple abscess pockets at the subcutaneous layer of anterior chest wall communicating with the joint cavity. Streptococcus agalactiae was isolated from blood culture. Intervention: She was treated with 6 weeks of antibiotic therapy. Outcomes: After antibiotic treatment, she was successfully treated without recurrence. Lessons: Besides surgery, medical treatment should also be considered for sternoclavicular joint septic arthritis, depending on patient status and the causative pathogen. Physicians should be aware of this rare disease to facilitate its prompt diagnosis and management.

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Streptococcus pyogenes Sternoclavicular Septic Arthritis in a Healthy Adult

Cited by 6 publications

References 18 publications

Sternoclavicular Septic Arthritis Caused by Streptococcus pyogenes in a Child

Sternoclavicular Septic Arthritis Caused by Streptococcus pyogenes in a Child

Septic Arthritis of the Knee and Necrotizing Fasciitis in a Young Immunocompetent Adult: A Case Report

Medical management of septic arthritis of sternoclavicular joint

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