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Bone and joint complications of Hemophilus influenzae meningitis
Abstract:
Seven patients with a bone or joint complications were identified among 202 cases treated for Hemophilus influenzae meningitis between 1970 and 1980. All patients studied met the minimal diagnostic criteria of pleocytosis of the cerebrospinal fluid (CSF) and CSF culture positive for H. influenzae. The diagnosis of bone or joint complication was based on objective findings of physical examination: swelling, erythema and decreased range of motion, and either an increased number of granulocytes in aspirated joint fluid or radiographic and/or radionuclide scan evidence of bone or joint disease. The only significant difference between the control patients and those with bone or joint complications was duration of fever; in the control group 29 per cent of patients were febrile seven or more days, compared with 100 per cent of complication group. Since a number of those patients who remain febrile beyond the sixth hospital day had presumptive evidence or bone or joint infection, we suggest a bone scan be considered for these patients.
Insights
Seven patients with Hemophilus influenzae meningitis developed bone or joint complications. Prolonged fever beyond six days suggests potential bone or joint infection, warranting consideration for bone scans in pediatric patients.
Area of Science:
- Pediatric Infectious Diseases
- Orthopedic Complications
- Bacterial Meningitis
Background:
- Hemophilus influenzae meningitis is a serious infection in children.
- Bone and joint complications can arise from meningitis.
- Early identification of complications is crucial for effective treatment.
Observation:
- A retrospective study identified 7 cases of bone or joint complications among 202 patients with Hemophilus influenzae meningitis (1970-1980).
- Patients with complications showed significantly longer fever duration compared to controls.
- Objective physical findings and diagnostic tests confirmed bone or joint involvement.
Findings:
- All patients with complications had prolonged fever (≥7 days).
- Prolonged fever in Hemophilus influenzae meningitis cases is a strong indicator of concurrent bone or joint infection.
- Cerebrospinal fluid (CSF) analysis confirmed meningitis, while joint fluid analysis or imaging confirmed bone/joint issues.
Implications:
- Consider bone scans for pediatric patients with Hemophilus influenzae meningitis who remain febrile beyond the sixth hospital day.
- Prompt diagnosis and management of bone and joint complications can improve patient outcomes.
- This finding highlights the importance of vigilant monitoring for secondary infections in meningitis patients.