Primary infectious costochondritis due to Prevotella nigrescens in an immunocompetent patient: clinical and imaging findings
- 32 Downloads
Infection of costal cartilage is a rare observation. We report the case of a 43-year-old male patient without relevant history who presented with a progressive painful swelling of the left chest wall since 4 months. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated an abscess within the left ninth costal cartilage with surrounding reactive changes. A CT-guided biopsy was performed and the culture of the sample revealed the presence of Prevotella nigrescens. Musculoskeletal infections by Prevotella are rarely described in the literature, Prevotella oralis and Prevotella bivia being the most frequently observed pathogens. These infections usually originate from a hematogenous spread after thoracic surgery or dental procedure. In our patient, conservative treatment was chosen. A clinical improvement was noted after 1-month antibiotherapy, confirmed by short-term and 6-month imaging follow-up showing the complete disappearance of all previously observed abnormalities.
KeywordsInfection Skeleton Chest Cartilage CT MRI Prevotella Costochondritis
Heartfelt thanks are expressed to Hector RODRIGUEZ-VILLALOBOS, MD, and Christine GALANT, MD, PhD, for clinical collaboration and stimulating discussions.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 14.Riesbeck K. Paronychia due to Prevotella bivia that resulted in amputation: fast and correct bacteriological diagnosis is crucial. J Clin Microbiol. 2003:4901–3.Google Scholar
- 19.Proulx AM, Tw Z. Costochondritis: diagnosis and treatment. Am Fam Phys. 2009;80(6):617–20.Google Scholar
- 20.Magano R, Cortez J, Ramos E, Trindade L. Candida albinas osteomyelitis as a cause of chest pain and visual loss. BMJ Case Rep Published online. https://doi.org/10.1136/bcr-2015-211327.
- 21.Crawford SJ, Swan CD, Boutlis CS, Reid AB. Candida costochondritis associated with recent intravenous drug use. IDCases. 2016:59–61.Google Scholar
- 25.Pineda C, Vargas A, Rodriguez AV. Imaging of osteomyelitis: current concepts. Infect Dis Clin North Am. 2006;20:789–825.Google Scholar