Acute septic arthritis of the acromioclavicular joint caused by Haemophilus parainfluenzae: a rare causative origin

Abstract

Septic arthritis of the acromioclavicular (AC) joint is a rare entity with symptoms that include erythema, swelling, and tenderness over the AC joint, fever, and limitation of shoulder motion with pain. In previous reports, Staphylococcus and Streptococcus species have been mentioned as common causative organisms. Haemophilus parainfluenzae is a normal inhabitant of the oral cavity, respiratory tract, gastrointestinal tract, and urogenital tract. However, it sometimes causes opportunistic infections leading to septic arthritis and osteomyelitis. AC joint infection associated with H.parainfluenzae is very rare, and only one case has been reported in the literature. Moreover, septic arthritis in immunocompetent patients is also very rare. Here, we report the case of a healthy patient with H. parainfluenzae-related septic arthritis of the AC joint.

Bone and Joint Infections due toHaemophilus parainfluenzae: Case Report and Review of the Literature

“…Inclusive of our case, there have been only 16 cases of bone and joint infections caused by H. parainfluenzae reported in the English literature (summarized in Table 2 ) [ 3 – 16 ]. Of these 16 patients, 10 (63%) had septic arthritis, four (25%) had osteomyelitis, and two (13%) had both septic arthritis and osteomyelitis.…”

Identification of polysaccharide capsules among extensively drug-resistant genitourinary Haemophilus parainfluenzae isolates

“…H. parainfluenzae is part of the human oropharyngeal and genitourinary microbiota and is increasingly recognised as an opportunistic pathogen causing invasive, chronic or recurrent diseases, including respiratory tract infections 3 , meningitis 4 , endocarditis and pericarditis 5 , bone and joint infections 6 , and arthritis 7 . Recent reports have also linked this pathogen to genitourinary and sexually transmitted infections 8–10 , with one study observing unexpectedly high genital carriage in pregnant women that was frequently associated with antibiotic resistance traits 8 .…”

Septic arthritis of the acromioclavicular joint: a case series and review of the literature

“…Other pathogens that have been reported include methicillin-resistant Staphylococcus epidermidis, Streptococcus pneumonia, S Steinmetz et al S Steinmetz et al Streptococcus viridans, Group B streptococcus, Ochrobactrum anthropi, and Haemophilus parainfluenzae. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Patients with septic AC arthritis have been shown to have a high percentage of positive blood cultures. 10 This suggests that there is often hematogenous spread and therefore we recommend blood cultures should be obtained.…”

“…This disease is most commonly seen in patients with a preexisting immunocompromised state; however, it has also been reported in patients without any predisposing comorbidities. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] With an increasing number of patients with compromised immune systems from etiologies such as diabetes, drug abuse, cancer, and chemotherapy, this disease process may become more prevalent in the future. We present a case series of three patients along with a review of the literature and propose an algorithm for diagnosing and treating septic arthritis of the AC joint.…”