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1.
J Infect Chemother ; 26(1): 124-127, 2020 Jan.
Article in English | MEDLINE | ID: mdl-31300377

ABSTRACT

Austrian syndrome is a rare condition caused by invasive Streptococcus pneumoniae, comprising a triad of pneumococcal meningitis, endocarditis, and pneumonia. Herein, we report a 59-year-old male patient who presented with fever and tenderness of the right shoulder. Although the initial diagnosis was acromioclavicular joint septic arthritis, the present case showed a reduced level of consciousness, pulmonary infiltrates, cerebral infarcts, and destruction of the mitral valve. This case suggests that acromioclavicular joint arthritis could be an initial presentation of pneumococcal infection inclusive of Austrian syndrome, especially in patients with some risk factors of invasive pneumococcal infections, such as chronic alcoholism.


Subject(s)
Acromioclavicular Joint/microbiology , Arthritis, Infectious , Endocarditis, Bacterial , Meningitis, Pneumococcal , Pneumonia, Pneumococcal , Anti-Bacterial Agents/therapeutic use , Arthritis, Infectious/diagnosis , Arthritis, Infectious/drug therapy , Arthritis, Infectious/microbiology , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/drug therapy , Endocarditis, Bacterial/microbiology , Humans , Male , Meningitis, Pneumococcal/diagnosis , Meningitis, Pneumococcal/drug therapy , Meningitis, Pneumococcal/microbiology , Middle Aged , Pneumonia, Pneumococcal/diagnosis , Pneumonia, Pneumococcal/drug therapy , Pneumonia, Pneumococcal/microbiology , Streptococcus pneumoniae , Syndrome
2.
BMC Infect Dis ; 19(1): 111, 2019 Feb 04.
Article in English | MEDLINE | ID: mdl-30717689

ABSTRACT

BACKGROUND: Osteoarticular tuberculosis is a great masquerader presenting in varied forms and in atypical locations, and it is prone to misdiagnosis and missed diagnosis. Isolated acromioclavicular joint tuberculosis has been reported rarely. CASE PRESENTATION: A 19-year-old man presented with a chronic, mild pain, non-healing ulcer in right shoulder. Imaging of the shoulder revealed destruction of the acromioclavicular joint and histopathology confirmed the diagnosis of acromioclavicular tuberculosis. The patient underwent debridement, synovectomy and drainage of the abscess and recovered well with antitubercular therapy postoperatively. CONCLUSIONS: Awareness of this uncommon presentation of osteoarticular tuberculosis may assist in earlier diagnosis. Especially, in endemic countries, osteoarticular tuberculosis should be considered as a differential diagnosis in all atypical presentations to avoid residual problems.


Subject(s)
Acromioclavicular Joint/microbiology , Tuberculosis, Osteoarticular/diagnosis , Abscess/diagnosis , Acromioclavicular Joint/pathology , Antitubercular Agents/therapeutic use , Debridement , Diagnosis, Differential , Drainage , Humans , Male , Shoulder Pain/diagnosis , Shoulder Pain/drug therapy , Shoulder Pain/microbiology , Shoulder Pain/surgery , Tuberculosis, Osteoarticular/drug therapy , Tuberculosis, Osteoarticular/surgery , Young Adult
3.
Int J Infect Dis ; 73: 27-29, 2018 Aug.
Article in English | MEDLINE | ID: mdl-29879522

ABSTRACT

Coxiella burnetii acromioclavicular infection is a new infectious focus, evidenced here for the first time using the gold standard, culture. Positron emission tomography had a crucial role in identifying the deep infectious focus, even when C. burnetii serological titres were low.


Subject(s)
Acromioclavicular Joint/microbiology , Antibodies, Bacterial/blood , Coxiella burnetii/isolation & purification , Q Fever/diagnosis , Female , Humans , Middle Aged , Positron-Emission Tomography
4.
Clin Orthop Surg ; 7(1): 131-4, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25729529

ABSTRACT

Acromioclavicular (AC) and sternoclavicular (SC) septic arthritis with contiguous pyomyositis are rare, especially in immunocompetent individuals. We report a case of septic AC joint with pyomyositis of the deltoid and supraspinatus muscles and a separate case with septic SC joint with pyomysitis of the sternocleidomastoid muscle. Both patients had similar presentations of infections with Staphylococcus aureus and were successfully treated with surgical incision and drainage followed by prolonged antibiotic therapy.


Subject(s)
Acromioclavicular Joint , Arthritis, Infectious/therapy , Pyomyositis/therapy , Staphylococcal Infections/therapy , Staphylococcus aureus , Sternoclavicular Joint , Acromioclavicular Joint/microbiology , Adult , Anti-Bacterial Agents/administration & dosage , Arthritis, Infectious/diagnosis , Arthritis, Infectious/microbiology , Female , Humans , Magnetic Resonance Imaging , Pyomyositis/diagnosis , Pyomyositis/microbiology , Staphylococcal Infections/complications , Sternoclavicular Joint/microbiology
5.
Clin Rheumatol ; 34(4): 811-4, 2015 Apr.
Article in English | MEDLINE | ID: mdl-24584486

ABSTRACT

Septic arthritis of the acromioclavicular (AC) joint is a rare entity with symptoms that include erythema, swelling, and tenderness over the AC joint, fever, and limitation of shoulder motion with pain. In previous reports, Staphylococcus and Streptococcus species have been mentioned as common causative organisms. Haemophilus parainfluenzae is a normal inhabitant of the oral cavity, respiratory tract, gastrointestinal tract, and urogenital tract. However, it sometimes causes opportunistic infections leading to septic arthritis and osteomyelitis. AC joint infection associated with H.parainfluenzae is very rare, and only one case has been reported in the literature. Moreover, septic arthritis in immunocompetent patients is also very rare. Here, we report the case of a healthy patient with H. parainfluenzae-related septic arthritis of the AC joint.


Subject(s)
Acromioclavicular Joint/microbiology , Arthritis, Infectious/drug therapy , Arthritis, Infectious/microbiology , Haemophilus Infections/drug therapy , Haemophilus Infections/microbiology , Haemophilus parainfluenzae , Anti-Bacterial Agents/therapeutic use , Arthritis, Infectious/diagnosis , Haemophilus Infections/diagnosis , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Opportunistic Infections , Osteomyelitis , Shoulder Pain
6.
Article in English | WPRIM (Western Pacific) | ID: wpr-119046

ABSTRACT

Acromioclavicular (AC) and sternoclavicular (SC) septic arthritis with contiguous pyomyositis are rare, especially in immunocompetent individuals. We report a case of septic AC joint with pyomyositis of the deltoid and supraspinatus muscles and a separate case with septic SC joint with pyomysitis of the sternocleidomastoid muscle. Both patients had similar presentations of infections with Staphylococcus aureus and were successfully treated with surgical incision and drainage followed by prolonged antibiotic therapy.


Subject(s)
Adult , Female , Humans , Acromioclavicular Joint/microbiology , Anti-Bacterial Agents/administration & dosage , Arthritis, Infectious/diagnosis , Magnetic Resonance Imaging , Pyomyositis/diagnosis , Staphylococcal Infections/complications , Staphylococcus aureus , Sternoclavicular Joint/microbiology
7.
Reumatol Clin ; 10(1): 37-42, 2014.
Article in English, Spanish | MEDLINE | ID: mdl-24094429

ABSTRACT

Septic pyogenic arthritis of the acromioclavicular joint is a rare entity that occurs in immunosuppressed patients or those with discontinuity of defense barriers. There are only 15 cases described in the literature. The diagnosis is based on clinical features and the isolation of a microorganism in synovial fluid or blood cultures. The evidence of arthritis by imaging (MRI, ultrasound or scintigraphy) may be useful. Antibiotic treatment is the same as in septic arthritis in other locations. Staphylococcus aureus is the microorganism most frequently isolated. Our objective was to describe the clinical features, treatment and outcome of patients diagnosed with septic arthritis of the acromioclavicular joint at a Rheumatology Department. We developed a study with a retrospective design (1989-2012). The medical records of patients with septic arthritis were reviewed (101 patients). Those involving the acromioclavicular joint were selected (6 patients; 6%).


Subject(s)
Acromioclavicular Joint/microbiology , Anti-Bacterial Agents/therapeutic use , Arthritis, Infectious/diagnosis , Arthritis, Infectious/drug therapy , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Adolescent , Adult , Aged , Female , Haemophilus Infections/diagnosis , Haemophilus Infections/drug therapy , Haemophilus parainfluenzae/isolation & purification , Humans , Male , Middle Aged , Retrospective Studies , Streptococcal Infections/diagnosis , Streptococcal Infections/drug therapy , Streptococcus agalactiae/isolation & purification , Treatment Outcome
8.
Joint Bone Spine ; 77(5): 466-9, 2010 Oct.
Article in English | MEDLINE | ID: mdl-20729119

ABSTRACT

The acromioclavicular joint is rarely the site of septic arthritis. We conducted a retrospective review at our rheumatology department, which identified five cases within the last 6 years. All five patients were males, and their mean age was 63 years. Risk factors were consistently identified and included intravenous substance abuse, prior joint disease, a recent history of intraarticular injections, and a remote history of surgery. Joint aspiration was performed in all five patients and provided the organism in two patients. Blood cultures recovered Staphylococcus aureus in three patients, a coagulase-negative Staphylococcus in one patient, and no organism in one patient. Ultrasonography and/or magnetic resonance imaging established the early diagnosis in four patients and ruled out concomitant involvement of the glenohumeral joint. Only about 20 cases of septic arthritis of the acromioclavicular joint have been reported to date. This rare infection must be diagnosed rapidly to prevent joint destruction. The treatment is that usually recommended for septic arthritis.


Subject(s)
Acromioclavicular Joint , Arthritis, Infectious/diagnosis , Acromioclavicular Joint/diagnostic imaging , Acromioclavicular Joint/microbiology , Adult , Aged , Arthritis, Infectious/drug therapy , Arthritis, Infectious/epidemiology , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Retrospective Studies , Risk Factors , Shoulder Pain/microbiology , Substance Abuse, Intravenous/epidemiology , Tomography, X-Ray Computed , Treatment Outcome
9.
Am J Orthop (Belle Mead NJ) ; 39(3): 134-6, 2010 Mar.
Article in English | MEDLINE | ID: mdl-20463985

ABSTRACT

In immunocompetent patients, septic arthritis of the acromioclavicular (AC) joint is a rare entity. It can be difficult to discern from glenohumeral septic arthritis and AC joint impingement syndrome. The usual symptoms are fever, erythema, swelling, palpable pain over the AC joint, and pain with shoulder motion. The most commonly reported causative organism is a Staphylococcus or Streptococcus species. Haemophilus parainfluenzae is a rare cause of septic arthritis in any joint. Although limited to case reports in the literature, most H parainfluenzae skeletal infections occur after surgical intervention. To our knowledge, this is the first case report of AC septic arthritis with H parainfluenzae.


Subject(s)
Acromioclavicular Joint/microbiology , Arthritis, Infectious/diagnosis , Haemophilus Infections/diagnosis , Haemophilus parainfluenzae , Acromioclavicular Joint/surgery , Aged , Anti-Bacterial Agents/therapeutic use , Arthritis, Infectious/drug therapy , Arthritis, Infectious/microbiology , Arthritis, Infectious/surgery , Debridement , Female , Haemophilus Infections/drug therapy , Haemophilus Infections/microbiology , Haemophilus Infections/surgery , Humans , Ofloxacin/therapeutic use , Therapeutic Irrigation , Treatment Outcome
12.
Skeletal Radiol ; 30(7): 388-92, 2001 Jul.
Article in English | MEDLINE | ID: mdl-11499779

ABSTRACT

OBJECTIVE: To describe the sonographic findings of septic arthritis of the acromioclavicular joint. DESIGN AND PATIENTS: A retrospective study of five male patients was carried out. Four of the patients were referred because of signs and symptoms suggestive of glenohumeral joint septic arthritis, one for signs and symptoms suggestive of septic arthritis of the acromioclavicular joint. All the acromioclavicular joints were evaluated with ultrasound, aspirated and the aspirate cultured. RESULTS: All patients had normal ultrasound findings of their glenohumeral joints and distended acromioclavicular joints as determined by ultrasound. Ultrasound examination elicited focal tenderness over the acromioclavicular joint. Aspirates of each acromioclavicular joint grew pyogenic organisms. CONCLUSION: Infection in the acromioclavicular joint is uncommon, but is seen in increased frequency in immune-compromised patients and intravenous drug users. A normal glenohumeral joint on ultrasound in a patient suspected of having a septic shoulder should prompt careful review of the acromioclavicular joint. Aspiration of the acromioclavicular joint is easily performed under ultrasound guidance.


Subject(s)
Acromioclavicular Joint/diagnostic imaging , Arthritis, Infectious/diagnostic imaging , Staphylococcal Infections/diagnosis , Staphylococcus aureus/isolation & purification , Streptococcal Infections/diagnosis , Streptococcus pneumoniae/isolation & purification , Acromioclavicular Joint/microbiology , Adult , Arthritis, Infectious/microbiology , Humans , Male , Middle Aged , Radiography , Staphylococcal Infections/diagnostic imaging , Streptococcal Infections/diagnostic imaging , Suction , Ultrasonography
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