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Brucellar sternoclavicular arthritis, the forgotten complication.
A M Mousa1, S A Muhtaseb, D S Al-Mudallal
1Adan Hospital, Ministry of Public Health, Kuwait.
Annals of Tropical Medicine and Parasitology
|June 1, 1988
Summary
Sternoclavicular (STCL) arthritis is a rare manifestation of brucellosis, affecting less than 1% of cases. Early diagnosis and combination antibiotic therapy are crucial for successful treatment of this serious joint infection.
Area of Science:
- Infectious Diseases
- Rheumatology
- Immunology
Background:
- Brucellosis is a zoonotic disease with diverse clinical presentations.
- Sternoclavicular (STCL) arthritis is an uncommon but severe complication of brucellosis.
Purpose of the Study:
- To describe the clinical characteristics and outcomes of brucellosis patients with STCL arthritis.
- To evaluate the efficacy of antibiotic therapy in these cases.
Main Methods:
- Retrospective analysis of 511 brucellosis cases from December 1983 to February 1986.
- Serological testing using indirect immunofluorescent (IIF) assay for specific IgG antibodies.
- Blood cultures for bacterial isolation.
- Clinical assessment of associated conditions and treatment response.
Main Results:
- Four cases (0.8%) presented with STCL arthritis.
- High specific IgG antibody titres and positive blood cultures confirmed Brucella infection.
- STCL arthritis was associated with various systemic complications, including hepatitis, renal impairment, and myelodysplasia.
- Combination antibiotic therapy (streptomycin, rifampicin, cotrimoxazole/tetracycline) for 6-8 weeks yielded excellent results.
Conclusions:
- Sternoclavicular arthritis is a rare but significant manifestation of brucellosis.
- Prompt diagnosis and aggressive multi-drug therapy are essential for managing this condition.
- Effective treatment regimens can lead to favorable outcomes even in complex cases.