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.