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Polyarticular Septic Arthritis Caused by Haemophilus Influenzae in an Asplenic Patient: A Case Report
Roberto Desarden1, Roya Caloia1
1Henry Ford Genesys Hospital, Department of Emergency Medicine, Grand Blanc, Michigan.
Introduction:
Prevalence of serious infections from Haemophilus influenzae has diminished over the last few decades because of immunizations against the most virulent serotype. However, over the last few years a handful of septic arthritis cases secondary to H influenzae have been documented. Most of the cases documented are in the pediatric and unimmunized population. This is a case of polyarticular septic arthritis in a 69-year-old male who presented with syncope and ankle pain.
Case Report:
A 69-year-old male presented to the emergency department after a syncopal event at home and complaining of right ankle pain. He was tachycardic and tachypneic on presentation and had an erythematous painful right ankle and right elbow. Aspiration of both joints produced purulent aspirate that grew H influenzae. Antibiotics were started, and the patient was taken to the operating room for emergent joint lavage. The patient made a full recovery and was discharged home with a peripherally inserted central catheter line for continued intravenous (IV) antibiotics.
Conclusion:
Our case highlights an atypical presentation for a case of polyarticular septic arthritis caused by H influenzae. We were unable to rule out endocarditis as a source of the bacterial seeding, and the patient improved with IV antibiotics and surgical lavage of the affected joints.
Insights
This case report details a rare instance of polyarticular septic arthritis caused by Haemophilus influenzae in a 69-year-old male. Prompt antibiotic treatment and joint lavage led to a full recovery.
Area of Science:
- Infectious Diseases
- Rheumatology
- Microbiology
Background:
- Haemophilus influenzae infections have decreased due to widespread immunization.
- Recent years have seen a resurgence of invasive H. influenzae infections, particularly septic arthritis.
- Most documented cases occur in pediatric and unvaccinated individuals.
Observation:
- A 69-year-old male presented with syncope and polyarticular septic arthritis affecting the ankle and elbow.
- Joint aspiration revealed purulent fluid positive for H. influenzae.
- The patient exhibited tachycardia and tachypnea upon presentation.
Findings:
- The patient received intravenous antibiotics and underwent emergent joint lavage.
- Treatment resulted in a complete recovery, with discharge on a peripherally inserted central catheter (PICC) line for continued IV antibiotics.
- Endocarditis was considered a potential source of bacterial seeding but could not be definitively ruled out.
Implications:
- This case highlights an unusual presentation of H. influenzae septic arthritis in an adult.
- It underscores the importance of considering H. influenzae in adult septic arthritis, even in immunized populations.
- Effective management involves timely antibiotic therapy and surgical intervention.
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