scholarly journals Polyarticular Septic Arthritis Due to Non-Typeable Haemophilus influenzae With Concomitant New-Onset Acute Gouty Arthritis

2019 ◽  
Vol 7 ◽  
pp. 232470961986499
Author(s):  
Brian Sanders ◽  
Mohammed Abdulfatah ◽  
Mossab Aljuaid ◽  
Ibrahim Tawhari

Haemophilus influenzae is serologically classified into two main categories based on the presence or absence of the polysaccharide capsule. Strains that possess polysaccharide capsules are identified as typeable Haemophilus influenzae, whereas strains that do not have capsules are identified as non-typeable Haemophilus influenza. Only on very rare occasions, Haemophilus influenzae affects adult joints, and almost 95% of cases have been identified as type b serotypes. Coexistence of gouty and septic arthritis is rare but has been reported. We herein report a case of polyarticular septic arthritis caused by non-typeable Haemophilus influenzae in an adult with concomitant new-onset gouty arthritis. The case was successfully treated with surgical debridement and a 4-week course of ceftriaxone.

mSphere ◽  
2017 ◽  
Vol 2 (2) ◽  
Author(s):  
Eric A. Porsch ◽  
Kimberly F. Starr ◽  
Pablo Yagupsky ◽  
Joseph W. St. Geme

ABSTRACT Kingella kingae has emerged as a significant cause of septic arthritis, osteomyelitis, and bacteremia in young children. A recent study examining a diverse collection of K. kingae isolates from Israel revealed four different polysaccharide capsule types in this species, designated types a to d. To determine the global distribution of K. kingae capsule types, we assembled and capsule typed an international collection of K. kingae isolates. The findings reported here show that the type a and type b capsules represent >95% of the invasive isolates, similar to the Israeli isolate collection, suggesting that a polysaccharide-based vaccine targeting these two capsules could be an attractive approach to prevent K. kingae disease. Kingella kingae is an encapsulated Gram-negative bacterium and an important etiology of osteoarticular infections in young children. A recent study examining a diverse collection of carrier and invasive K. kingae isolates from Israel revealed four distinct polysaccharide capsule types. In this study, to obtain a global view of K. kingae capsule type diversity, we examined an international collection of isolates using a multiplex PCR approach. The collection contained all four previously identified capsule types and no new capsule types. Over 95% of invasive isolates in the collection were type a or type b, similar to the findings in Israel. These results suggest that the type a and type b polysaccharide capsules may have enhanced pathogenic properties or may mark clonal groups of strains with specific virulence genes. In addition, they raise the possibility that a vaccine containing the type a and type b capsules might be an effective approach to preventing K. kingae disease. IMPORTANCE Kingella kingae has emerged as a significant cause of septic arthritis, osteomyelitis, and bacteremia in young children. A recent study examining a diverse collection of K. kingae isolates from Israel revealed four different polysaccharide capsule types in this species, designated types a to d. To determine the global distribution of K. kingae capsule types, we assembled and capsule typed an international collection of K. kingae isolates. The findings reported here show that the type a and type b capsules represent >95% of the invasive isolates, similar to the Israeli isolate collection, suggesting that a polysaccharide-based vaccine targeting these two capsules could be an attractive approach to prevent K. kingae disease.


2015 ◽  
Vol 30 (6) ◽  
pp. 700 ◽  
Author(s):  
Kwang-Hoon Lee ◽  
Sang-Tae Choi ◽  
Soo-Kyung Lee ◽  
Joo-Hyun Lee ◽  
Bo-Young Yoon

2019 ◽  
Vol 12 (7) ◽  
pp. e230432
Author(s):  
Dillon Tinevez ◽  
Nebojsa Nick Knezevic

We present an elderly diabetic man with left hallux pain and drainage who was initially diagnosed with acute gouty arthritis using the diagnostic rule for acute gout and monosodium urate crystals presented on synovial fluid analysis. Further investigation with surgical debridement, plain X-ray, MRI and wound culture revealed concomitant Citrobacter koseri septic arthritis with osteomyelitis. C. koseri is considered an opportunistic infection that rarely causes musculoskeletal infections. Acute gouty arthritis and septic arthritis are rarely seen occurring concomitantly in the same joint and are often difficult to differentiate due to similar findings on exam and imaging. The present case illustrates that osteomyelitis with an opportunistic organism can present concomitantly with acute gouty arthritis, and the diagnosis of one should not exclude the other.


PEDIATRICS ◽  
1985 ◽  
Vol 75 (2) ◽  
pp. 254-259
Author(s):  
Harley A. Rotbart ◽  
Mary P. Glode

Twenty-three cases of Haemophilus influenzae type b septic arthritis seen over a recent 5-year period are reviewed. The natural history of the disease includes a mean three days of fever and joint symptoms prior to hospitalization, often accompanied or immediately preceded by a viral illness and/or otitis media. Concurrent H influenzae type B meningitis was present in 30% of patients and concurrent osteomyelitis in 22%. Infants remained febrile in the hospital for a mean of 3.6 consecutive days. However, secondary and prolonged fevers were common. Clinical improvement in the joint examination was first seen at a mean of 2.5 days. Characteristic laboratory findings during recovery included a decline in total WBC count, neutrophil count, ESR, and hematocrit, with a concomitant increase in lymphocyte and platelet counts. Outpatient follow-up for a mean duration of 20 months found only two of 21 infants with residual impairment. The time to total healing in the remaining 19 infants, however, varied widely—from nine days to 17 months (mean of 4 months).


2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Raheel Ahmed Ali ◽  
Sheldon L. Kaplan ◽  
Scott B. Rosenfeld

Background. The standard use of vaccinations against pathogens has resulted in a decreased incidence of musculoskeletal infections caused by these previously common bacterial pathogens. Consequently, the incidence of infections caused by atypical bacteria is rising. This report presents a case of septic arthritis caused by non-type bH. influenzaein a pediatric patient.Methods. We report a case of an infant with polyarticular septic arthritis caused byH. influenzaeserotype f. A literature review was conducted with the inclusion criteria of case reports and studies published between 2004 and 2013 addressing musculoskeletalH. influenzaeinfections.Results. An 8-month-old female presented with pain and swelling in her right ankle and left elbow. The patient was diagnosed with septic arthritis and underwent incision and drainage. Wound and blood cultures were positive forHaemophilus influenzaeserotype f. In addition to treatment with IV antibiotics, the patient underwent immunocompetency studies, which were normal. Subsequent follow-up revealed eradication of the infection.Conclusions.Haemophilus influenzaenon-type b may cause serious invasive infections such as sepsis or septic arthritis in children with or without predisposing factors such as immunodeficiency or asplenia. Optimal treatment includes surgical management, culture driven IV antibiotics, and an immunologic workup.


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