Abstract:
Infection of the sternoclavicular joint is exceptionally rare, accounting for less than 1% of bone infections. This case report describes an unusual presentation of MRSA-positive septic arthritis in a 60-year-old male with a complex medical history, including hypertension, diabetes mellitus, hepatitis C, and recurrent cellulitis due to multiple IV and IM injections, presented with drowsiness and a painful, erythematous swelling of the left anterior chest wall. Clinical examination revealed pallor, distended abdomen, and decreased left-sided airway entry. Diagnostic workup showed elevated creatinine, metabolic acidosis, and inflammatory markers. Imaging revealed extensive soft tissue swelling and a mediastinal mass. A core biopsy confirmed severe acute and chronic inflammation, abscess formation, and granulation tissue suggestive of an infectious etiology. CT scans further identified sternoclavicular septic arthritis, a rare diagnosis. The patient responded well to IV antibiotics and chest physiotherapy. The presence of a mass extending into the left superior mediastinum, mimicking a malignancy, adds to the diagnostic challenge. Our findings highlight the need for careful evaluation and management in such unique clinical scenarios. Our case report describes MRSA-positive sternoclavicular septic arthritis in a patient with a history of tramadol and multivitamin injections. Sternoclavicular joint (SCJ) infection is rare, complicating differentiation from mediastinal malignancies. Successful management required embolization, IV antibiotics, and physiotherapy. Our case highlights diagnostic challenges and underscores tailored treatment strategies for complex infections.