Polyarticular Septic Arthritis Caused by Haemophilus influenzae Serotype f in an 8-Month-Old Immunocompetent Infant: A Case Report and Review of the Literature

Polyarticular Haemophilus Influenza Septic Arthritis in an HIV Patient

Haemophilus influenzae is an opportunistic gram-negative bacterium most commonly found in the upper respiratory tract of humans. With the advent of vaccines, most infections caused by these bacteria have been suppressed. However, in the immunocompromised host, an invasive infection may occur, particularly within the musculoskeletal system. In this paper, we present the case of a 55-year-old male with septic shock secondary to polyarticular Haemophilus influenza infection. The patient was successfully treated with surgical irrigation and debridement, and antibiotics. Haemophilus infections should be part of the differential in patients with musculoskeletal pain and immunocompromise to avoid potential delays in surgical management.

INVASIVE NON-TYPE B HAEMOPHILUS INFLUENZAE DISEASE: REPORT OF EIGHT CASES

OBJECTIVE

To describe eight cases of invasive non-type b Haemophilus influenzae disease in children admitted to Hospital de Clínicas of Universidade Estadual de Campinas.

CASES DESCRIPTION

In 2015, there were eight cases of invasive non-type b H. influenzae disease. We tested the ampicillin sensitivity and beta-lactamase production of the strains identified and performed the genotyping. Molecular typing was determined by Pulsed-Field Gel Electrophoresis. Four patients were diagnosed with bacteremia; in two cases, H. influenzae was detected in the pleural fluid, and two patients had meningitis. Patients with comorbidities represented 37.5% of cases. Except for the strain of one patient - not sent to the reference laboratory -, all were ampicillin-sensitive and non-beta-lactamase-producing. Genotyping identified four non-capsular, one type c, and two type a strains. Molecular typing ruled out nosocomial transmission since all serotypes were distinct regarding genotype.

COMMENTS

The rise in cases of invasive non-type b H. influenzae infection was real. There was no nosocomial transmission, and we found no justification for the increase. These data indicate the need for surveillance to correctly diagnose, monitor, and understand the spectrum of non-type b H. influenzae disease.

Haemophilus influenzae serotype f endocarditis and septic arthritis

Haemophilus influenzae represents gram-negative coccobacilli which can cause endocarditis, meningitis, septicemia, pneumonia, septic arthritis. H.influenzae exists as encapsulated and unencapsulated (non-typeable) strains. Non-typeable H.influenzae are emerging pathogens especially in elderly population. We report a case of a 73 year old woman with bacteremia, endocarditis and septic arthritis due to H.influenzae serotype f. This case emphasizes the clinical features and the key elements of diagnosis and management of infections caused by non-typeable strains of H.influenzae.