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CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2018; 59(01): 035-039
DOI: 10.1055/s-0037-1615255
Case Report | Caso Clínico
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Absceso subpectoral como diagnóstico diferencial de hombro doloroso – reporte de un caso

Subpectoral Abscess as a Differential Diagnosis of Painful Shoulder – A Case Report
José Palma Concha
1   Médico Residente de Traumatología y Ortopedia, Universidad de Concepción, Concepción, Chile
,
Andrés Gómez Meier
1   Médico Residente de Traumatología y Ortopedia, Universidad de Concepción, Concepción, Chile
,
Enrique Herrera Otto
2   Médico Traumatólogo, Director del Instituto de Seguridad del Trabajo, Talcahuano, Chile
,
Juan Besser Mahuzier
3   Médico Traumatólogo, Instituto de Seguridad del Trabajo, Talcahuano, Chile
,
George Ayres Henriquez
3   Médico Traumatólogo, Instituto de Seguridad del Trabajo, Talcahuano, Chile
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Publikationsverlauf

22. Mai 2017

27. November 2017

Publikationsdatum:
08. Januar 2018 (online)

   Lizenzen und Reprints

Resumen

Los síndromes dolorosos del hombro son relativamente comunes en la práctica clínica. Habitualmente son causados por un número limitado de patologías. Dentro de los diagnósticos diferenciales, el pinzamiento subacromial, las lesiones aisladas del manguito rotador, capsulitis adhesiva, tendinitis cálcica, patología degenerativa de las articulaciones glenohumeral y acromioclavicular, y la inestabilidad crónica del hombro, son causas comunes. Causas infrecuentes son la rotura del tendón del bíceps, neuralgias, patología infecciosa articular y tumores del hombro. Un absceso subpectoral sin sintomatología infecciosa clara es una causa extremadamente rara de hombro doloroso en el adulto. Presentamos el caso de un paciente de 60 años, que inicia con un cuadro de hombro doloroso cuya causa se identifica como un absceso subpectoral por staphylococcus aureus que se maneja con drenaje quirúrgico y tratamiento antibiótico endovenoso con buenos resultados.

Abstract

Painful shoulder syndromes are commonly caused by a limited assortment of pathologies. Differential diagnosis include rotator cuff impingement syndrome, rotator cuff tears, adhesive capsulitis, calcific tendonitis, degenerative disease of the joint including acromio-clavicular and gleno-humeral joints and chronic instability. Less common causes are labral tears, biceps tendon rupture, soft tissue infection, neurologic disease, joint infection and shoulder tumors. A subpectoral abscess without infectious clinical features is a very rare cause of shoulder pain in adults. We present the case of a 52 years old male who develops a painful shoulder syndrome caused by a staphylococcus aureus subpectoral abscess, treated by surgical drainage and intravenous antibiotic therapy with good results.

Palabras clave

absceso - hombro doloroso - infecciones estafilocócicas - manguito rotador

Keywords

abscess - painful shoulder - rotator cuff - staphylococcus infection
 

  • Referencias

  • 1 Luime JJ, Koes BW, Hendriksen IJ. , et al. Prevalence and incidence of shoulder pain in the general population; a systematic review. Scand J Rheumatol 2004; 33 (02) 73-81 . Doi: 10.1080/03009740310004667
    CrossrefPubMedGoogle Scholar
  • 2 Frost A, Robinson C. The painful shoulder. Surgery 2006; 24 (11) 363-367 . Doi: 10.1053/j.mpsur.2006.09.007
    PubMedGoogle Scholar
  • 3 Ross JJ. Septic Arthritis of Native Joints. Infect Dis Clin North Am 2017; 31 (02) 203-218 . Doi: 10.1016/j.idc.2017.01.001
    CrossrefPubMedGoogle Scholar
  • 4 Weston VC, Jones AC, Bradbury N, Fawthrop F, Doherty M. Clinical features and outcome of septic arthritis in a single UK Health District 1982-1991. Ann Rheum Dis 1999; 58 (04) 214-219 . Doi: 10.1136/ard.58.4.214
    CrossrefPubMedGoogle Scholar
  • 5 Edwards SA, Cranfield T, Clarke HJ. Atypical presentation of septic arthritis in the immunosuppressed patient. Orthopedics 2002; 25 (10) 1089-1090
    PubMedGoogle Scholar
  • 6 Park GY, Kwon DR, Kim JK. Subpectoral abscess with anterior chest pain caused by Staphylococcus aureus. Am J Phys Med Rehabil 2014; 93 (05) 456-457 . Doi: 10.1097/PHM.0b013e318278a5c7
    CrossrefPubMedGoogle Scholar
  • 7 Angadi DS, Nagappa S, Simpson D, Morgan I. Streptococcus subpectoral abscess with shoulder pain: A rare emergency with a common symptom?. Int J Shoulder Surg 2010; 4 (01) 22-23 . Doi: 10.4103/0973-6042.68419
    CrossrefPubMedGoogle Scholar
  • 8 Abuelreish MA, Rathore MH. Subpectoral abscess a rare group A beta-hemolytic Streptococcus infection. Pediatr Infect Dis J 2005; 24 (12) 1121-1122
    CrossrefPubMedGoogle Scholar
  • 9 Le Goff B, Berthelot JM, Guillot P, Glémarec J, Maugars Y. Assessment of calcific tendonitis of rotator cuff by ultrasonography: comparison between symptomatic and asymptomatic shoulders. Joint Bone Spine 2010; 77 (03) 258-263 . Doi: 10.1016/j.jbspin.2010.01.012
    CrossrefPubMedGoogle Scholar
  • 10 Bouvet C, Gjoni S, Zenelaj B, Lipsky B, Hakko E, Uçkay I. Staphylococcus aureus soft tissue infection may increase the risk of subsequent staphylococcal soft tissue infections. Int J Infect Dis. May 2017. Artículo aceptado, no publicado. Consultado: el 18 de Mayo 2017. Disponible en: http://www.ijidonline.com/article/S1201-9712(17)30138-8/pdf
    PubMedGoogle Scholar
  • 11 Milch H. Acute subpectoral abscess. Ann Surg 1928; 87 (04) 517-527
    CrossrefPubMedGoogle Scholar
  • 12 Weber Z, Ariano R, Lagacé-Wiens P, Zelenitsky S. Multifaceted antibiotic treatment analysis of methicillin-sensitive Staphylococcus aureus bloodstream infections. Int J Antimicrob Agents 2016; 48 (06) 674-679 . Doi: 10.1016/j.ijantimicag.2016.09.007
    CrossrefPubMedGoogle Scholar
  • 13 Dubost J, Couderc M, Tatar Z. , et al. Three-decade trends in the distribution of organisms causing septic arthritis in native joints: single-center study of 374 cases. Joint Bone Spine 2014; 81 (05) 438-440 . Doi: 10.1016/j.jbspin.2014.05.001
    CrossrefPubMedGoogle Scholar