Escherichia coli bacteremia with secondary seeding in the sternoclavicular joint: A case report and literature review.

Background: Septic arthritis of the sternoclavicular joint (SCJ) is a rare phenomenon in healthy individuals. It is generally described in patients with predisposing risk factors such as diabetes mellitus, intravenous drug use, immunosuppression, chronic liver disease and central venous catheters.

Methods: We describe a case of Escherichia coli related SCJ septic arthritis in an otherwise healthy adult with review of the literature.

Conclusions: There were only two previous reports of patients with E. coli and to our knowledge, this is the third case of a patient with SCJ septic arthritis secondary to E. coli without predisposing factors. A review of literature on SCJ septic arthritis among otherwise healthy adults showed that pain and redness of the SCJ are the most common presentation symptoms, with Staphylococcus aureus being the most common causative organism. More than half of these patients required surgical intervention for associated complications, but all patients had complete recovery with appropriate treatment with no reported mortality. Conclusions: SCJ infection is rare and has a significant morbidity. It should be identified and treated properly to avoid the development of complications. Imaging studies are used to assist in making the diagnosis, and culture results help to identify the pathogen.