Sternoclavicular Septic Arthritis Caused by Streptococcus pyogenes in a Child

Paez-Perez, Yenisleidy; McGovern, Terrance; Flannery, Ashley; Naim, Farid

doi:10.5811/cpcem.2017.5.33811

Cited by 3 publications

(8 citation statements)

References 11 publications

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“…CT or MRI should be obtained because of their 93% and 100% sensitivities in diagnosis, respectively. 15…”

Section: Discussionmentioning

confidence: 99%

“…Patients should be transitioned to culture-specific antibiotics based on bone marrow aspirate from the infected site or culturable specimens from I&D. Surgical intervention with I&D is indicated if there is no clinical improvement noted within 36 hours of starting medical treatment, evidence of subperiosteal abscess, or spread of infection to an adjacent joint. 15,16 Patients should remain on antibiotics for at least 4 to 6 weeks. 4,17 Antibiotic regimens typically commence with parenteral antibiotics, followed by oral.…”

Section: Discussionmentioning

confidence: 99%

“…CT or MRI should be obtained because of their 93% and 100% sensitivities in diagnosis, respectively. 15 Once diagnosed, patients should promptly begin treatment with broad-spectrum parenteral antibiotics. Clindamycin or vancomycin is preferred because of its optimal MRSA coverage.…”

Section: Discussionmentioning

confidence: 99%

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Delayed Diagnosis of Pediatric Sternoclavicular Joint Infections and Clavicular Osteomyelitis During the COVID-19 Pandemic: A Report of 3 Cases

Benson¹,

Kothari²,

Torrez³

et al. 2022

JAAOS Glob Res Rev

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Sternoclavicular joint infections and osteomyelitis of the clavicle are extremely rare infections, especially in the pediatric population. Early signs of these infections are nonspecific and can be mistaken for common upper respiratory infections such as COVID-19 and influenza. Rapid diagnosis and treatment are critical for preventing potentially fatal complications such as mediastinitis. We present three cases of sternoclavicular joint infections in the past year during the COVID-19 pandemic. All three patients had delayed diagnoses likely secondary to COVID-19 workup. Each patient underwent surgical irrigation and débridement. Two of three patients required multiple surgeries and prolonged antibiotic courses. Placement of antibiotic-impregnated calcium sulfate beads into the surgical site cleared the infection in all cases where they were used. All three patients made a full recovery; however, the severity of their situations should not be overlooked. Children presenting to the hospital with chest pain, fever, and shortness of breath should not simply be discharged based on a negative COVID-19 test or other viral assays. A higher index of suspicion for bacterial infections such as clavicular osteomyelitis is important. Close attention must be placed on the physical examination to locate potential areas of concentrated pain, erythema, or swelling to prompt advanced imaging if necessary.

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“…CT or MRI should be obtained because of their 93% and 100% sensitivities in diagnosis, respectively. 15…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Delayed Diagnosis of Pediatric Sternoclavicular Joint Infections and Clavicular Osteomyelitis During the COVID-19 Pandemic: A Report of 3 Cases

Benson¹,

Kothari²,

Torrez³

et al. 2022

JAAOS Glob Res Rev

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…This joint is affected in only 1% of septic arthritis cases and is characterized by pain with motion of the arm and shoulder on the affected side, pain and erythema of the skin overlying the joint, and elevated white blood cell count and C-reactive protein. 10 A pit or sinus tract in the lateral neck always brings to mind a branchial sinus as a leading diagnosis on the differential. 11 In this particular location no true brachial sinus has been reported in the English literature.…”

Section: Discussionmentioning

confidence: 99%

Masses of the Sternoclavicular Area: Case Series and Review of the Literature

Oviedo

Bliss

2021

Clin Med Insights Pediatr

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Objective: Masses of the sternoclavicular area are rare, and are not well described in the literature. We aim to present a series of patients with masses in this location and to review all reported English language cases of sternoclavicular masses in pediatric patients. Methods: This is a case series of pediatric patients with masses of the sternoclavicular area presenting to a tertiary care pediatric hospital from 2010 through 2017. Data was collected by using ICD-9 and ICD-10 codes to query the electronic medical record. Chart review included age at presentation, mass characteristics, medical and surgical interventions, and pathology results. A review of the literature was then performed. Results: Ten patients with masses overlying the sternoclavicular area were identified. Four patients presented with abscess and were treated with incision and drainage. Three of these patients were then treated with staged excision once infection cleared. Two additional patients were treated with primary excision. Four patients were treated with observation. The most common histopathologic finding was epidermoid. One patient was found to have a dermoid cyst, and 1 had a congenital cartilaginous rest. Conclusion: Epidermoids and dermoids are the most common masses overlying the sternoclavicular area. Controversy remains regarding the embryologic origin of sternoclavicular masses. The differential for masses in this area also includes branchial remnants, bronchogenic cysts, ganglion cysts, or septic arthritis.

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Sternoclavicular Septic Arthritis Caused by Cutibacterium acnes in a Previously Healthy 13-Year-Old Male

Reid

McKnight

Secrist

et al. 2021

JBJS Case Connector

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Case: A 13-year-old boy presented with 3 weeks of atraumatic left-sided sternoclavicular (SC) joint pain, swelling, and decreased range of motion. After imaging and laboratory workup, he underwent operative irrigation, debridement, and antibiotic therapy with complete resolution of his symptoms. Surgical cultures were consistent with SC septic arthritis. Conclusion: The management of septic arthritis in pediatric patients remains varied. Here, we present the only report of SC septic arthritis due to Cutibacterium acnes in a healthy pediatric patient. Given the similar clinical findings of pain and swelling to affected bones and joints, differentiating SC septic arthritis from other conditions within the clinical spectrum of chronic nonbacterial osteomyelitis remains challenging. Clinicians should maintain a high index of suspicion when patients present with pain and swelling over the SC joint.

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Sternoclavicular Septic Arthritis Caused by Streptococcus pyogenes in a Child

Cited by 3 publications

References 11 publications

Delayed Diagnosis of Pediatric Sternoclavicular Joint Infections and Clavicular Osteomyelitis During the COVID-19 Pandemic: A Report of 3 Cases

Delayed Diagnosis of Pediatric Sternoclavicular Joint Infections and Clavicular Osteomyelitis During the COVID-19 Pandemic: A Report of 3 Cases

Masses of the Sternoclavicular Area: Case Series and Review of the Literature

Sternoclavicular Septic Arthritis Caused by Cutibacterium acnes in a Previously Healthy 13-Year-Old Male

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