Suppurative Arthritis of the Manubriosternal Joint.

A previously healthy 46-year-old man without a surgical history was admitted to our hospital complaining of acute onset chest pain and a fever (38.2℃). At the time of admission, no pathological findings were revealed via a physical examination, computed tomography, electrocardiogram, or echocardiogram. The C-reactive protein level was 8.23 mg/dL. However, localized tenderness, redness, and swelling at the manubriosternal joint appeared two days later, and a blood culture was positive for Streptococcus agalactiae. Magnetic resonance imaging revealed arthritis of the manubriosternal joint and osteomyelitis of the sternum (Picture a and b, white arrows). After the intravenous administration of antibiotics (ceftriaxone followed by ampicillin) for 14 days, oral amoxicillin was continued for 5 weeks. Risk factors such as intravenous drugs abuse, immunosuppressive drugs, and inflammatory joint diseases (1) were not detected. Clinicians should therefore consider this rare arthritis as the reason for a fever with chest pain, even in cases without any risk factors.

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The authors state that they have no Conflict of Interest (COI).