title: Appearances are Deceptive: Staphylococcus Superinfection of Clavicular Tuberculous Osteomyelitis.
abstract: A man, aged 25 years, presented with pain, swelling, and drainage from the right clavicular area. He had a past history of abscess at the sternoclavicular joint. The cultures from the drainage site grew methicillin-sensitive Staphylococcus aureus, and he was placed on appropriate antibiotics. As S. aureus infection of the clavicle is often secondary in nature, particularly in adults, a thorough workup was done to identify the underlying cause. Quantiferon gold, done as a part of the workup, came back positive, while the bone cultures grew S. aureus and Mycobacterium tuberculosis. He was placed on 9 months of combination therapy for tuberculosis osteomyelitis with a good clinical outcome.
authors.affiliation: Department of Internal Medicine, Marshfield Clinic, Marshfield WI, USA Department of Laboratory Medicine, Marshfield Clinic, Marshfield WI, USA nepperla@mcw.edu.
authors.forename: Narendranath
authors.initials: N
authors.lastname: Epperla
authors.affiliation: Department of Internal Medicine, Marshfield Clinic, Marshfield WI, USA.
authors.forename: Siddhartha
authors.initials: S
authors.lastname: Kattamanchi
authors.affiliation: Department of Laboratory Medicine, Marshfield Clinic, Marshfield WI, USA.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Fritsche
mesh_terms: D000328:Adult; D002968:Clavicle / Q000382:microbiology*; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000150:complications / Q000175:diagnosis*; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000209:etiology; D015163:Superinfection / Q000175:diagnosis* / Q000209:etiology; D014394:Tuberculosis, Osteoarticular / Q000150:complications / Q000175:diagnosis*
keywords: Clavicle; Staphylococcus aureus; Tuberculous osteomyelitis