Sternoclavicular septic arthritis due to methicillin-resistant Staphylococcus aureus in a patient with a suprapubic catheter.

Abstract

We report a case of a 74-year-old man who presented to the emergency department with a 1-week history of fever. He had a meatal stenosis and had a suprapubic catheter for 10 months, and had a recent hospitalisation for urosepsis with bacteraemia due to methicillin-resistant Staphylococcus aureus after manipulation of the catheter. Clinical examinations were performed in the emergency department and the patient was hospitalised with the diagnosis of recurrent urinary tract infection. The following day, we noticed the development of a mass in the left sternoclavicular joint with inflammatory signs and excruciating pain. Ultrasonographic findings led to the diagnosis of left sternoclavicular synovitis, and methicillin-resistant S. aureus grew in blood cultures leading to the diagnosis of sternoclavicular septic arthritis. Treatment with vancomycin and gentamicin was started and maintained for 4 weeks with complete resolution of symptoms and no complications or sequelae.

• Authors: Nadine Monteiro, Filipa Moleiro, Graça Lérias, Alberto Mello Silva
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2015 (Feb 18 2015) ISSN: 1757-790X [Electronic] England
• PMID: 25694643 (Publication Type: Case Reports, Journal Article)
• Copyright: 2015 BMJ Publishing Group Ltd.

Chemical References

• Anti-Bacterial Agents
• Gentamicins
• Vancomycin

Topics

• Aged
• Anti-Bacterial Agents (therapeutic use)
• Arthritis, Infectious (complications, diagnostic imaging, drug therapy)
• Catheters
• Diagnosis, Differential
• Gentamicins (therapeutic use)
• Humans
• Male
• Methicillin-Resistant Staphylococcus aureus (isolation & purification)
• Staphylococcal Infections (complications, diagnostic imaging, drug therapy)
• Sternoclavicular Joint (diagnostic imaging)
• Synovitis (complications, diagnostic imaging, drug therapy)
• Treatment Outcome
• Ultrasonography
• Vancomycin (therapeutic use)