title: 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.affiliation: Department of Internal Medicine, Centro Hospitalar Lisboa Ocidental, EPE - Hospital Egas Moniz, Lisboa, Portugal.
authors.forename: Nadine
authors.initials: N
authors.lastname: Monteiro
authors.affiliation: Department of Internal Medicine, Centro Hospitalar Lisboa Ocidental, EPE - Hospital Egas Moniz, Lisboa, Portugal.
authors.forename: Filipa
authors.initials: F
authors.lastname: Moleiro
authors.affiliation: Department of Internal Medicine, Centro Hospitalar Lisboa Ocidental, EPE - Hospital Egas Moniz, Lisboa, Portugal.
authors.forename: Graça
authors.initials: G
authors.lastname: Lérias
authors.affiliation: Department of Internal Medicine, Centro Hospitalar Lisboa Ocidental, EPE - Hospital Egas Moniz, Lisboa, Portugal.
authors.forename: Alberto Mello
authors.initials: AM
authors.lastname: Silva
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D057785:Catheters; D003937:Diagnosis, Differential; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D013203:Staphylococcal Infections / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D013247:Sternoclavicular Joint / Q000000981:diagnostic imaging*; D013585:Synovitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D016896:Treatment Outcome; D014463:Ultrasonography; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D014640:Vancomycin