Appearances are Deceptive: Staphylococcus Superinfection of Clavicular Tuberculous Osteomyelitis

Epperla, Narendranath; Kattamanchi, Siddhartha; Fritsche, Thomas R.

doi:10.3121/cmr.2014.1247

Cited by 6 publications

(3 citation statements)

References 21 publications

(21 reference statements)

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“…The confirmation of M. tuberculosis infection and the identification of co-infection with S. aureus added layers of complexity to the case. A superimposed staphylococcal infection on a clavicle infected with TB is a rare presentation, with only a few cases reported to date [10]. This highlights the importance of thorough microbiological examination to tailor the treatment plan effectively [11].…”

Section: Discussionmentioning

confidence: 99%

Challenges and Triumphs: Unusual Presentation of Tuberculosis in the Cuboid Bone Successfully Managed Through Surgical and Medical Intervention

Patel,

Shrivastava,

Pundkar

et al. 2024

Cureus

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This case report describes the unusual presentation of tuberculosis (TB) affecting the cuboid bone in a 16year-old male patient. The patient presented with a one-year history of progressive foot pain, a discharging sinus, evening rise of temperature, weight loss, and loss of appetite. Clinical examination revealed soft tissue swelling and the presence of caseous material oozing from the sinus. Emergency debridement and curettage were performed, and bone cementing was carried out. An intraoperative sample was sent for a culture sensitivity test, histological analysis, and cartridge-based nucleic acid amplification test (CBNAAT). Histopathological examination, CBNAAT, and culture and sensitivity tests confirmed the diagnosis of Mycobacterium tuberculosis infection. Post-operatively, anti-tuberculous treatment was started. The patient fully recovered from TB of the cuboid.

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Section: Discussionmentioning

confidence: 99%

Challenges and Triumphs: Unusual Presentation of Tuberculosis in the Cuboid Bone Successfully Managed Through Surgical and Medical Intervention

Patel,

Shrivastava,

Pundkar

et al. 2024

Cureus

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“…Staphylococcus coinfection can mask the symptoms of tuberculous osteomyelitis and cause a delay in diagnosis [ 11 ]. Simply managing such a case with antibiotics for staphylococcal osteomyelitis may lead to the infection appearing to settle initially, but the underlying TB would go untreated causing repeated abscess, sinuses, and continued destruction of the bone [ 12 ]. The infection may progress, affecting the sternoclavicular or acromioclavicular and may necessitate excision of a large section of the sequestered clavicle [ 13 ], which may prove to be troublesome who require to lift heavy objects overhead.…”

Section: Discussionmentioning

confidence: 99%

Combined Pyogenic and Tuberculous Osteomyelitis of the Clavicle: A Case Report

Jagiasi¹,

Upadhyaya²,

Mehta³

2021

JOCR

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Introduction: Tuberculous osteomyelitis of the clavicle accounts for 1–3% of cases of osteoarticular tuberculosis. It presents with non-specific symptoms and may have superadded infections with pyogenic organisms, requiring a high degree of suspicion to adequately diagnose and initiate appropriate treatment. Case Report: We describe a case of a 35-year-old male with osteolytic clavicular lesion and abscess in the supraclavicular fossa. Tissue diagnosis revealed tuberculous osteomyelitis with superadded infection with Staphylococcus aureus. He was managed with debridement and anti-tubercular therapy. Conclusion: A high degree of suspicion is required to adequately test and diagnose the cause of osteomyelitis of the clavicle, in the absence of a predisposing event, as staphylococcal and tuberculous infection can present simultaneously. Keywords: Clavicle, tuberculosis, osteomyelitis.

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“…Mycobacterium tuberculosis can spread both hematogenously and contiguously from an apical pulmonary tuberculous focus (64). An unusual presentation of Mycobacterium tuberculosis SCJI was reported in a patient after malaria infection (65,66). sickle cell disease and thalassemia (68).…”

Section: Infectious Etiologymentioning

confidence: 99%

Diagnosis and management of sternoclavicular joint infections: a literature review

2020

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The sternoclavicular joint (SCJ) is anatomically and clinically significant considering its proximity to important neuro-vascular structures like the subclavian vessels and the phrenic nerve. Infections of this joint masquerade multiple disorders, delay diagnosis and spread to the bone and deep tissues. There is no standardized workup and treatment protocol for sternoclavicular joint infections (SCJI) as defined in literature. Here, we review the existing literature to understand the current knowledge of the diagnosis and treatment of SCJI. We searched English publications in PubMed and included clinical trials, case reports, case series, retrospective cohort studies, literature and systematic reviews after excluding non-infectious etiology of SCJ pathologies. There are many risk factors for SCJI, such as immunocompromised status, intravenous drug use, trauma and arthropathies. But a large percentage of patients with disease have none of these risk factors. SCJIs can present with fever, joint swelling, immobility, and rarely with vocal cord palsy or dysphagia. While Staphylococcus aureus causes over 50% of SCJI cases, other pathogens such as Pseudomonas and Mycobacterium are frequently seen. When diagnosed early, the infection can be medically managed with antibiotics or joint aspirations. Most cases of SCJI, however, are diagnosed after extensive spread to soft tissue and bones requiring en-bloc resection with or without a muscle flap. Complications of undertreatment can range from simple abscess formation to mediastinitis, even sepsis. SCJIs are rare but serious infections prompting early detection and interventions. Most cases of SCJI treated adequately show complete resolution in months while retaining maximum functionality. Key features of proper healing include aggressive physiotherapy to prevent adhesive shoulder capsulitis and decreased range of motion.

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Appearances are Deceptive: Staphylococcus Superinfection of Clavicular Tuberculous Osteomyelitis

Cited by 6 publications

References 21 publications

Challenges and Triumphs: Unusual Presentation of Tuberculosis in the Cuboid Bone Successfully Managed Through Surgical and Medical Intervention

Challenges and Triumphs: Unusual Presentation of Tuberculosis in the Cuboid Bone Successfully Managed Through Surgical and Medical Intervention

Combined Pyogenic and Tuberculous Osteomyelitis of the Clavicle: A Case Report

Diagnosis and management of sternoclavicular joint infections: a literature review

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