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Methicillin-resistant Staphylococcal aureus patellar tendon abscess and septic prepatellar bursitis in an injection

Michael Glass1, Brian Everist1, Douglas Nelson1

  • 1Department of Radiology, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 4032, Kansas City, KS 66160, USA.

Radiology Case Reports
|November 28, 2018
PubMed

Insights

A knee abscess in the patellar tendon and septic bursitis occurred in an injection drug user. Early diagnosis requires considering clinical history alongside imaging for this rare musculoskeletal infection.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Radiology

Background:

  • Direct inoculation of pathogens can lead to musculoskeletal infections.
  • Injection drug use is a risk factor for various infections, including those affecting joints and tendons.

Observation:

  • A 26-year-old male presented with acute knee pain, swelling, and erythema.
  • Imaging revealed an enlarged patellar tendon with a complex fluid collection suggestive of an abscess.
  • Aspiration confirmed purulent fluid, and methicillin-resistant Staphylococcus aureus was identified.

Findings:

  • Intratendinous patellar abscess and prepatellar septic bursitis were diagnosed.
  • Operative debridement confirmed the abscess and its extension to the prepatellar bursa.
  • Radiographic findings were typical but nonspecific for abscess in this unusual location.

Implications:

  • This case highlights the importance of considering direct inoculation and clinical history in diagnosing atypical musculoskeletal infections.
  • Early recognition and treatment are crucial for managing deep-seated infections in injection drug users.
  • Standard imaging modalities can aid in diagnosing abscesses in unusual locations, complementing clinical suspicion.
Keywords:
AbscessBursitisMethicillin-resistant Staphylococcus aureusTendon injuries

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