Osteoarticular infection associated with the human immunodeficiency virus

An analysis is presented of 20 patients with the human immunodeficiency virus (HIV) infection who were treated for skeletal infection in our hospital. Seventeen cases of septic arthritis and three of osteomyelitis were found. All patients were intravenous drug abusers, 75% were male and all were younger than 40 years old. Eighty-eight percent of the septic arthritis cases were monarticular, the hip joint being the area most commonly affected (29%), and Staphylococcus aureus and Candida albicans were the most frequently isolated agents (60% and 20%, respectively). Gram negative bacteria were not found. No correlation between the number of CD4 lymphocytes, affected joints, isolated microorganism or functional capacity was found. Four of 17 patients with septic arthritis and 2 of 3 with osteomyelitis fulfilled the CDC criteria for the diagnosis of acquired immunodeficiency syndrome (AIDS). All cases except one responded to conventional therapy. We conclude that skeletal infection in HIV-infected patients is more closely associated with the risk-group than with HIV itself.