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Clinical and microbiological findings of septic arthritis caused by Haemophilus parainfluenzae
F Cobo1, G Jiménez1, J Rodríguez-Granger1
1Department of microbiology, hospital Virgen de las Nieves, 2, Avda Fuerzas Armadas, 18014 Granada, Spain.
Objectives:
To report a case of septic arthritis due to H. parainfluenzae and to review the clinical and microbiological characteristics of published case patients.
Patients And Methods:
Data was collected on age, sex, infection localization, underlying risk factors, symptom onset-diagnosis interval, analytical findings, microbiological diagnosis, treatment, outcome, and follow-up of the present patient (presenting with septic arthritis of the pubic symphysis due to H. parainfluenzae) and those identified in a literature analysis.
Results:
Data of 18 patients, including 17 reported case patients, was collected. Mean age at presentation was 51±9 years. Underlying diseases for septic arthritis were recorded in 11 patients. The infection site was the knee in eight patients, hip and/or acromioclavicular joint in five. Pain was observed in 15 patients and fever in 10; the mean symptom onset-diagnosis interval was 9.4 days. Diagnosis was obtained from synovial fluid aspirate in 12 patients and from blood cultures in four. Susceptibility of H. parainfluenzae strains was reported in 12 cases. Eight patients were treated with cephalosporins and 10 with penicillins. A favorable outcome was observed in 13 patients.
Conclusions:
Septic arthritis caused by H. parainfluenzae is a rare entity that requires a high level of suspicion before application of laboratory methods for rapid diagnosis and treatment.
Insights
Septic arthritis caused by Haemophilus parainfluenzae is rare but treatable. Early suspicion and laboratory diagnosis are crucial for favorable outcomes in patients with this joint infection.
Area of Science:
- Infectious Diseases
- Rheumatology
- Microbiology
Background:
- Septic arthritis, a serious joint infection, is typically caused by common bacteria.
- Haemophilus parainfluenzae is an uncommon pathogen for septic arthritis, making diagnosis challenging.
Observation:
- This study reports a case of septic arthritis due to H. parainfluenzae and reviews 17 similar cases from literature.
- The mean age of affected patients was 51 years, with underlying conditions noted in 11 cases.
- Commonly affected joints included the knee (8 patients) and hip/acromioclavicular joint (5 patients).
Findings:
- Pain and fever were prevalent symptoms, with a mean diagnostic delay of 9.4 days.
- Diagnosis was primarily achieved through synovial fluid analysis (12 patients) and blood cultures (4 patients).
- Most patients (13/18) experienced favorable outcomes following treatment with cephalosporins or penicillins.
Implications:
- Septic arthritis due to H. parainfluenzae is a rare condition requiring heightened clinical suspicion.
- Prompt laboratory investigation, including synovial fluid and blood cultures, is essential for accurate diagnosis.
- Timely administration of appropriate antibiotics leads to positive patient outcomes.
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