Hemophilus influenzae septic arthritis. A mimicker of gonococcal arthritis

Abstract

The rare occurrence of septic arthritis due to Hemophilus influenzae in an adult with systemic lupus erythematosus is reported. The clinical presentation mimicked disseminated gonococcemia with associated gonococcal arthritis. The features of this case as well as other bacterial infections known to cause confusion with gonococcal arthritis are reviewed, and the clinical and laboratory characteristics of septic arthritis caused by H influerrzae are described.In children, infections from Type B Hemophilus influenzae are both well-recognized clinical problems and common occurrences. In adults however, infections due to this organism are rare (1). In this report we describe an adult female with an established diagnosis of systemic lupus erythematosus (SLE) who presented with an H influenzae Address reprint requests to Dr Newcornbe. Submitted for publication July 23, 1973; accepted October 11, 1973. septic arthritis and pustular skin lesions mimicking gonococcal arthritis. Those bacterial infections that cause a septic arthritis with clinical findings similar to gonococcal arthritis are reviewed, and the special features of H influenzae septic arthritis and its immunologic aspects are emphasized. CASE REPORTCM, a 22-year-old female with SLE, was admitted to the Medical Center Hospital of Vermont with a severely painful, swollen left elbow. Five days prior to admission the patient had fallen and struck her right elbow. The following day she experienced a shaking chill associated with a frontal headache. Two days prior to admission she began to experience pain in her right foot and noted a red, swollen area over the plantar surface of the first and second metatarsal heads and discomfort in her left elbow and right wrist. That evening she developed an erythematous, tender area over the anterior aspect of her left shin which limited flexion and extension movements of her left foot. Shortly after midnight on the day of admission, the patient awakened with fever and severe pain in her left elbow.Her manifestations of SLE had been controlled by aspirin, 4.8 g/day; hydroxychloroquine, 200 mg/ day; and triamcinalone, 6 mg/day. She had never

Hemophilus influenzae Meningitis in the Elderly

“…It was suggested that this was the result of aggressive antibiotic therapy in early childhood 6 . However, adults with demonstrable bactericidal antibodies have developed bacteremic HI infections 7,8 . Therefore, it doesn't seem probable that HI antibodies play an important role in the protection against severe HI infections.…”

Pseudopodagra from Hemophilus Influenza in an Adult

“…This is the first case of pseudopodagra due to Hemophilus influenza and only the thirteenth reported case of hemophilus pyarthrosis in an adult (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). In Huskisson's classic paper on pseudopodagra, fourteen causes of podagra other than gout are recorded, including infection (1 3).…”