Ten cases of septic arthritis due to Pseudomonas occurred in users of
heroin. Nine cases were monarticular, two each occurring in the
sternoclavicular and the sacro-iliac joints. Review of the literature
suggests that the incidence of Pseudomonas septic arthritis is increasing,
especially among heroin addicts. The reported cases in adults suggest a
predilection for the sternoclavicular joints (eight of forty-one) which is
even more pronounced among addicts (seven of twenty-four). Pseudomonas
infection associated with drug abuse should be suspected in cases of
isolated sternoclavicular inflammation. The drugs used for treatment of
septic arthritis due to Pseudomonas should include gentamicin and
carbenicillin, in conjunction with adequate drainage by aspiration or
surgery.