scholarly journals Septic arthritis of the manubriosternal joint presenting as a chest-wall swelling in an immunocompetent patient

2019 ◽  
Vol 2019 (11) ◽  
Author(s):  
Adam O’Connor ◽  
Sanjay Furtado
Keyword(s):  
Chest Pain ◽  
Conservative Treatment ◽  
Septic Arthritis ◽  
Chest Wall ◽  
Immunocompetent Patient ◽  
Good Recovery ◽  
Manubriosternal Joint ◽  
Pain Symptoms

Abstract Septic arthritis of the manubriosternal joint is a rare pathology, often mistaken for other disease processes given its location and chest pain symptoms. We present a case of a 58-year-old man presenting with a dull ache in his chest after returning from a holiday. Initially under the care of the physicians locally, he was investigated for respiratory and cardiac causes of chest pain with no findings. Eventually, a lump was noted on examination of the chest prompting further imaging, which confirmed a diagnosis of manubriosternal septic arthritis. He was discussed and referred to tertiary cardiothoracics, who recommended conservative treatment with 6 weeks of antibiotics. To date, there has been a good recovery. We present this case alongside a discussion of the limited literature, in particular highlighting how difficult a diagnosis it is to make but one that surgeons and medics alike should be aware of.

scholarly journals An Atypical Cause of Atypical Chest Pain

2014 ◽  
Vol 25 (5) ◽  
pp. 253-254
Author(s):  
Ahmad Zaheen ◽  
Reed A Siemieniuk ◽  
Patrick Gudgeon
Keyword(s):  
Chest Pain ◽  
Septic Arthritis ◽  
Surgical Intervention ◽  
Present Report ◽  
Hiv Positive ◽  
Resonance Imaging ◽  
Rare Presentation ◽  
Atypical Chest Pain ◽  
Present Case Report ◽  
Manubriosternal Joint

The present report describes a case involving a 57-year-old HIV-positive man who presented with acute retrosternal chest pain accompanied by 24 h of fever. Septic arthritis of the manubriosternal joint was diagnosed based on magnetic resonance imaging findings in addition toStaphylococcus aureusbacteremia. To the authors’ knowledge, the present case is only the 12th reported case of manubriosternal septic arthritis, and the first in an HIV-positive patient. Early diagnosis and treatment can circumvent the need for surgical intervention. Based on the present case report and review of the literature, the authors summarize the epidemiology, appropriate imaging and suggestions for antibiotic therapy for this rare presentation.

Rare case of Ureaplasma parvum septic arthritis in an immunocompetent patient

2020 ◽  
Vol 13 (9) ◽  
pp. e236396
Author(s):  
Abuzar Ali Asif ◽  
Moni Roy ◽  
Sharjeel Ahmad
Keyword(s):  
Septic Arthritis ◽  
Rare Case ◽  
Immunocompetent Patient ◽  
Next Generation ◽  
Ureaplasma Parvum ◽  
Urogenital Infections ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Diagnostic Modalities

Mycoplasmatacea family comprises two genera: Mycoplasma and Ureaplasma. Ureaplasma parvum (previously known as U. urealyticum biovar 1) commonly colonises the urogenital tract in humans. Although Ureaplasma species have well-established pathogenicity in urogenital infections, its involvement in septic arthritis has been limited to prosthetic joint infections and immunocompromised individuals. We present a rare case of native right knee infection due to U. parvum identified using next-generation sequencing of microbial cell-free DNA testing and confirmed with PCR assays. This rare case of Ureaplasma septic arthritis was diagnosed using newer next-generation DNA sequencing diagnostic modalities and a literature review of prior cases, antibiotic coverage and antimicrobial resistance is incorporated as part of the discussion.

scholarly journals Pain in Patients with Panic Disorder: Relation to Symptoms, Cognitive Characteristics and Treatment Outcome

2002 ◽  
Vol 7 (3) ◽  
pp. 134-141 ◽  
Author(s):  
Norman B Schmidt ◽  
Helen T Santiago ◽  
John H Trakowski ◽  
J Michael Kendren
Keyword(s):  
Treatment Outcome ◽  
Chest Pain ◽  
Panic Disorder ◽  
Joint Pain ◽  
Behavioural Therapy ◽  
Depression Symptoms ◽  
Diagnostic And Statistical Manual ◽  
Cognitive Behavioural ◽  
Stomach Pain ◽  
Pain Symptoms

OBJECTIVE:Although there has been a link between certain types of pain, notably chest pain, and panic disorder, the relation between pain and panic disorder has not been systematically evaluated. In the present study, the relation between pain symptoms (headache, chest pain, stomach pain, joint pain) and the clinical presentation of patients with panic disorder was evaluated.HYPOTHESES:Pain was generally hypothesized to be related to increased symptoms of anxiety, panic-relevant cognitive domains and treatment outcome. In terms of specific pain domains, headache and chest pain were expected to be more closely related to anxiety-related symptoms.PARTICIPANTS AND METHODS:Patients (n=139) meeting the criteria of theDiagnostic and Statistical Manual of Mental Disorders - Fourth Editionfor panic disorder completed a set of standardized clinician-rated and self-reported measures. Moderator analyses were used in a subset of these patients completing a treatment outcome study.RESULTS:Approximately two-thirds of the participants endorsed at least one current pain symptom. The hypotheses were partially supported, with pain being associated with higher levels of anxiety and depression symptoms, as well as panic frequency. Pain was also related to several cognitive features, including anxiety sensitivity and panic appraisals. Headache and chest pain were more highly associated with anxiety symptoms than was joint pain. Cognitive measures did not mediate the relation between anxiety and pain, and pain did not significantly moderate outcome in response to cognitive-behavioural therapy.CONCLUSIONS:Co-occurring pain symptoms appear to be more highly related to phenomenology than to treatment response in patients with panic disorder.

scholarly journals Primary Tubercular Chest Wall Abscess in a Young Immunocompetent Male

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Shweta Sharma ◽  
R. K. Mahajan ◽  
V. P. Myneedu ◽  
B. B. Sharma ◽  
Nandini Duggal
Keyword(s):  
Chest Wall ◽  
Immunocompetent Patient ◽  
Rare Entity ◽  
Hematogenous Spread ◽  
Clinical Challenge ◽  
Chest Wall Abscess ◽  
Direct Inoculation ◽  
Underlying Pathology ◽  
Patient Infection ◽  
Rule Out

Chest wall tuberculosis is a rare entity especially in an immunocompetent patient. Infection may result from direct inoculation of the organisms or hematogenous spread from some underlying pathology. Infected lymph nodes may also transfer the bacilli through lymphatic route. Chest wall tuberculosis may resemble a pyogenic abscess or tumour and entertaining the possibility of tubercular etiology remains a clinical challenge unless there are compelling reasons of suspicion. In tuberculosis endemic countries like India, all the abscesses indolent to routine treatment need investigation to rule out mycobacterial causes. We present here a case of chest wall tuberculosis where infection was localized to skin only and, in the absence of any evidence of specific site, it appears to be a case of primary involvement.

A palpable chest wall mass in a 4-year-old boy

2021 ◽  
pp. e20200053
Author(s):  
Jakob M Domm ◽  
Joanne M Langley
Keyword(s):  
Chest Pain ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Chest Wall ◽  
Respiratory Infection ◽  
Lower Respiratory Tract ◽  
Atypical Presentation ◽  
History Of ◽  
Wall Mass ◽  
Chest Wall Mass

Empyema necessitans (EN) is a rare but dangerous complication of a lower respiratory tract infection. The diagnosis can be difficult to make and therefore delayed. We describe a case of a child with an atypical presentation of EN. He was afebrile and without chest pain and presented with a palpable chest wall mass after a history of recent respiratory infection. The threshold of suspicion for EN should be low, and it must be suspected in all children with a chest wall mass and recent history of respiratory infection.

Chest Pain

PEDIATRICS ◽  
1986 ◽  
Vol 77 (4) ◽  
pp. 618-618
Author(s):  
STEVEN M. SELBST
Keyword(s):  
Chest Pain ◽  
Chest Wall ◽  
Clinical Entity ◽  
Distinct Clinical Entity ◽  
Intercostal Nerves

In Reply.— Dr Rogers describes brief anterior chest pain, worse with inspiration, which he has labeled "benign pleuralgia." The etiology of this pain, as with most chest pain, is uncertain. Perhaps, the pain arises in the pain-sensitive pleura and then travels through the intercostal nerves in the chest wall. If such pain is not reproducible with palpation, and not related to recent exercise, I would not consider this to be of musculoskeletal origin. Although some may prefer to consider this a distinct clinical entity, I would "lump" such vague, unexplainable pain in the idiopathic category.

**C135** Chap. 6th

2020 ◽  
pp. 362-394
Author(s):  
Richard J. Kahn
Keyword(s):  
New Jersey ◽  
Chest Pain ◽  
Chest Wall ◽  
Standard Treatment ◽  
Princeton University ◽  
College Of New Jersey

Barker relates some unusual cases such as empyema (pus between lung and chest wall) in a fifty-five-year-old minister who was treated, drained, and lived for an additional thirty-eight years. A president of the College of New Jersey (later Princeton University) who had long-standing lung symptoms wrote a letter stating that he was such a devotee of venesection that he bought himself a lancet for self-treatment. In 1811 Barker’s twenty-five-year-old daughter, Eliza, daughter of a consumptive mother, developed chest pain, hacking cough, fever, and wasting. She received standard treatment by a physician acquaintance but rejected her father’s and a consultant’s suggestion to be bled. Eliza deteriorated, finally agreed to be bled, and was cured after five months of symptoms. She married in June and was doing well twenty years later. In Barker’s opinion, prevention should focus on proper clothing for women for “If the breast is left open to facilitate the entrance of Cupid’s darts, it affords a more certain mark for the envenomed shafts of the grisly king of terrors” (Joseph Young, 1809).

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