PEDIATRICS Vol. 75 No. 2 February 1985, pp. 254-259
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Haemophilus influenzae Type b Septic Arthritis in Children: Report of 23 Cases

Harley A. Rotbart MD1 and Mary P. Glode MD1

1 From The C. Henry Kempe Center for Investigative Pediatrics and Department of Pediatric Medicine, The Children's Hospital; Department of Pediatrics, University of Colorado School of Medicine, Denver

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).

Key Words: septic arthritis • Haemophilus influenzae type b.

Revised on February 17, 1984
Accepted on March 29, 1984




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