SHM Converge Scientific Abstract ePoster Gallery-Red-Hot Joint to Cool Recovery: Successful Treatment of Septic Arthritis With Dalbavancin

Pdf Summary

This case describes a 38-year-old previously healthy man who presented with two weeks of progressive right sternoclavicular swelling, shoulder pain, fever, and night sweats. Exam showed a warm, erythematous, tender right upper chest/neck region with limited arm range of motion. CT and MRI demonstrated septic arthritis of the sternoclavicular joint, osteomyelitis of the right clavicular head, and small surrounding muscle abscesses.<br /><br />He was initially treated with broad-spectrum IV antibiotics, then narrowed to cefazolin after joint aspiration grew methicillin-susceptible Staphylococcus aureus (MSSA). Despite treatment, he had minimal improvement and rising inflammatory markers, with repeat ultrasound showing re-accumulation of fluid. He underwent operative irrigation and debridement of the sternoclavicular joint and pectoralis major. A transthoracic echocardiogram also showed a small mitral valve echodensity concerning for infectious endocarditis, though blood cultures remained negative.<br /><br />After clinical improvement, he was discharged on dalbavancin 1,500 mg, with additional outpatient doses planned at 1 and 6 weeks. The report highlights dalbavancin’s long half-life and favorable safety profile as a way to treat deep MSSA infections without prolonged daily IV therapy or central venous access. This approach reduced the patient’s hospital stay to five days, compared with the usual 7–13 days or longer for septic arthritis requiring surgery.<br /><br />The case emphasizes that sternoclavicular septic arthritis, while rare, can occur even in healthy adults and may be difficult to diagnose because of its subtle onset and proximity to vital structures. It also supports dalbavancin as a practical outpatient option for selected bone and joint infections, including cases with osteomyelitis and possible endovascular involvement.

Asset Subtitle

Jessica Cristallo

Meta Tag

Author List Caitlin Sarubbi, Jessica Cristallo, Lucas Dziesinski

Category Clinical Vignettes

Concept Sternoclavicular Joint Septic Arthritis

Concept Methicillin-Susceptible Staphylococcus aureus

Concept Long-Acting Lipoglycopeptides

Concept Imaging

Concept Joint Aspiration

Distinguished Non-Finalist

Presenter Organization Montefiore Medical Center

Presenting Author Jessica Cristallo

Track Adult

Keywords

sternoclavicular septic arthritis

osteomyelitis

MSSA

dalbavancin

irrigation and debridement

staphylococcus aureus

mitral valve echodensity

infectious endocarditis

bone and joint infection

outpatient antibiotic therapy

Sternoclavicular Joint Septic Arthritis

Methicillin-Susceptible Staphylococcus aureus

Long-Acting Lipoglycopeptides

Imaging

Joint Aspiration