# Bilateral septic acromioclavicular arthritis in a farm worker with high suspicion of zoonotic disease: a case report

## TL;DR

A 54-year-old farm worker developed a rare infection in both shoulder joints, likely from animal contact, and was successfully treated.

## Contribution

This case report highlights a rare bilateral septic acromioclavicular arthritis in a farm worker with possible zoonotic transmission.

## Key findings

- The patient had bilateral septic acromioclavicular arthritis caused by MSSA.
- The infection likely originated from zoonotic transmission due to farm work.
- Successful treatment was achieved following standard guidelines despite a pre-existing condition.

## Abstract

We report the case of a 54-year-old male with the rare entity of bilateral septic acromioclavicular (AC) arthritis with osteomyelitis of the lateral clavicle with methicillin-susceptible Staphylococcus aureus (MSSA). The glenohumeral joint was affected as well. The patient was immunocompetent with no history of diabetes or intravenous drug abuse. There is a high possibility of a transmission from farm animals.

The case files including laboratory measurements, imaging and documentation were used to reassess the case and complete the case report. Regular clinical follow-up was done in our outpatient clinic. We compared our case with the literature and existing guidelines.

We report this rare entity of bilateral septic AC arthritis to ensure early diagnosis and proper treatment in the future. In comparison to the existing guidelines, we followed similar treatment concepts. The outcome of our patient was satisfactory despite a pre-existing rotary cuff tear, which might need further treatment in the future.

This report of a rare case can help to understand this infectious disease in the future and help establish treatment guidelines. In farm workers, one should be highly suspicious of transmission through animals and establish a quick and effective treatment as we did in this case.