Septic arthritis due to pseudomonas in heroin addicts

Ten cases of septic arthritis due to Pseudomonas occurred in users of heroin. Nine cases were monarticular, two each occurring in the sternoclavicular and the sacro-iliac joints. Review of the literature suggests that the incidence of Pseudomonas septic arthritis is increasing, especially among heroin addicts. The reported cases in adults suggest a predilection for the sternoclavicular joints (eight of forty-one) which is even more pronounced among addicts (seven of twenty-four). Pseudomonas infection associated with drug abuse should be suspected in cases of isolated sternoclavicular inflammation. The drugs used for treatment of septic arthritis due to Pseudomonas should include gentamicin and carbenicillin, in conjunction with adequate drainage by aspiration or surgery.