# Unusual Sternoclavicular Joint Infection With Pseudomonas in a Young Adult With Hidradenitis Suppurativa: A Case Report

## TL;DR

A rare case of Pseudomonas infection in the sternoclavicular joint is reported in a young adult with hidradenitis suppurativa.

## Contribution

This case highlights an unusual infection site and pathogen in a patient with a chronic skin condition.

## Key findings

- A 31-year-old male with hidradenitis suppurativa developed a Pseudomonas aeruginosa sternoclavicular joint infection.
- MRI findings suggested osteomyelitis and cellulitis, and treatment with ceftazidime and ciprofloxacin led to improvement.
- The case emphasizes the importance of considering uncommon pathogens in atypical infection locations.

## Abstract

Sternoclavicular joint infection is a relatively rare and serious condition, and its association with Pseudomonas aeruginosa is uncommon. Moreover, hidradenitis suppurativa is a chronic inflammatory skin disease that may predispose patients to deep-seated infections, as illustrated by this unusual report. We present a case of a 31-year-old male patient with a Pseudomonas aeruginosa sternoclavicular joint infection. The subject presented for a three-month history of swollen, erythematous, and tender right sternoclavicular joint, refractory to non-steroidal anti-inflammatory drugs (NSAIDs) and steroid injections. As past medical history, the patient has hidradenitis suppurativa that was quiescent at the time of presentation. MRI of the right shoulder showed findings suggestive of osteomyelitis and cellulitis. Soft tissue culture showed a Pseudomonas aeruginosa infection, and blood cultures yielded no growth. He showed clinical improvement and normalization of inflammatory markers with intravenous ceftazidime for two weeks, and he was discharged home on oral ciprofloxacin for four weeks. In this context, we underscore the need to consider uncommon pathogens in atypical infection sites.