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June 1982

Disseminated Brucellosis Initially Seen as Sternoclavicular Arthropathy

Author Affiliations

From the Division of Infectious Diseases, Department of Medicine, Harbor-UCLA Medical Center, Torrance, Calif (Drs Lam, Silverstein, Carlisle, and Bayer); and the UCLA School of Medicine, Los Angeles (Dr Bayer).

Arch Intern Med. 1982;142(6):1193-1194. doi:10.1001/archinte.1982.00340190149023

Bone and joint syndromes, including arthralgia, suppurative arthritis, spondylitis, and osteomyelitis, are noted in approximately 10% of brucellosis cases.1 We have recently treated a patient with disseminated brucellosis, who was seen with clinical, radioisotopic, microbiologic, and surgical evidence of sternoclavicular septic arthritis, a rare site of Brucella involvement.

REPORT OF A CASE  A 33-year-old Mexican man was admitted to Harbor-UCLA Medical Center, Torrance, Calif, with a two-month history of fever, night sweats, 9-kg weight loss, and right shoulder pain. He also had noted intermittent left-sided testicular pain. Until his move to the United States four months before admission to the hospital, he had worked on a farm in Mexico handling adult pigs and goats as well as their aborted fetuses. Findings from a physical examination disclosed an oral temperature of 41 °C and a 2 × 2-cm, firm, erythematous, tender mass overlying the suprasternal notch and right sternoclavicular joint.