Hemophilus Influenzae Infectious Arthritis in an Adult: Cephalothin Therapy: Review of Previous Cases

Abstract

A case of Hemophilus influenzae arthritis in a penicillin-sensitive female adult was successfully treated with large dosages of cephalothin intravenously. Upon admission to the hospital the patient gave a history of an upper respiratory-tract infection; her temperature was 104" F. Her right shoulder was hot and painful; aspiration produced about 12 ml of grossly purulent fluid. The sputum contained an abundance of pus cells and many Gram-positive cocci. Improvement started within forty-eight hours after starting cephalothin therapy, and the patient was afebrile after the fourteenth day. Cultures of the sputum, blood and joint fluid grew H. influenzae, found to be sensitive to several antibiotic drugs including cephalothin. There were no radiographic changes nor any demonstrable loss of function. A review of the 9 previously reported cases in adults is also presented.Hemophilus influenzae is a common etiologic agent in the infectious arthritis of infants and young children (1). In adults, it is exceedingly rare. Since Weaver and Sherwood's (2) first documented case, 9 cases have been described in the English literature. In this article, we report the tenth case. Moreover, t o our knowledge, this is the first case of H. influenzae arthritis successfully treated with cephalothin, which was given because of a history of penicillin hypersensitivity. CASE REPORTThis 62-year-old Negro female was in her usual good state of health until three days before admission. At that time, a nonproductive cough developed in association with a "scratchy" sensation in the throat. Within the

Septic Arthritis following Renal Transplantation

“…Similar progression of documented H. influenza upper re spiratory infection to monoarticular arthritis has been de scribed [7,8], None of the patients had leukopenia at the time of arthritis, but none had frank leukocytosis. Severe transient granulocytopenia occurred in case 3,42 days pre ceding the arthritis.…”