SHM Converge Scientific Abstract ePoster Gallery-A Case of Non-Typeable Haemophilus Influenzae Polyarticular Joint Infection

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This case describes a 68-year-old man with no known immunocompromising condition who developed polyarticular septic arthritis caused by beta-lactamase-negative, nontypeable <em>Haemophilus influenzae</em>. He initially presented with two weeks of flu-like symptoms, weakness, and dyspnea, then was found to have a painful, swollen right knee. He later developed a tender, fluctuant mass over the right sternoclavicular (SC) joint, indicating spread to multiple joints and adjacent structures.

Diagnostic workup showed pre-antibiotic blood and sputum cultures positive for nontypeable <em>H. influenzae</em>. Synovial fluid from the knee was turbid and highly inflammatory, with a neutrophil count of 213,000, though culture was sterile. Imaging demonstrated punctate gas in the right knee on CT, and CT/MRI of the SC joint revealed soft tissue thickening, marrow edema in the sternal manubrium, joint distension, and a 2 x 2 x 1 cm abscess.

Treatment included narrowing antibiotics to ceftriaxone, incision and drainage of the right knee with debridement, antibiotics, and implant retention (DAIR), and surgical debridement of the SC joint with vacuum-assisted closure (VAC). 

The authors emphasize that polyarticular septic arthritis due to <em>H. influenzae</em> is rare, particularly in immunocompetent adults. Most reported cases occur in immunocompromised patients or as unusual presentations in otherwise healthy individuals. This case is notable because it involved both a native and a prosthetic joint, and it illustrates the need to maintain a high suspicion for septic arthritis even when musculoskeletal symptoms are not the chief complaint. Collaboration across specialties is critical to prevent permanent joint damage and other sequelae.

Asset Subtitle

Victor P. Abdow III

Meta Tag

Author List Sarah Thornton, Victor P. Abdow III

Category Clinical Vignettes

Concept Haemophilus influenzae

Concept Nontypeable Haemophilus influenzae

Concept Polyarticular septic arthritis

Concept Septic Arthritis

Concept Sternoclavicular Joint Septic Arthritis

Distinguished Non-Finalist

Presenter Organization Georgetown University School of Medicine

Presenting Author Victor P. Abdow III

Track Adult

Keywords

Haemophilus influenzae

polyarticular septic arthritis

nontypeable

beta-lactamase-negative

sternoclavicular joint

prosthetic joint infection

immunocompetent adult

ceftriaxone

synovial fluid

incision and drainage

Haemophilus influenzae

Nontypeable Haemophilus influenzae

Polyarticular septic arthritis

Septic Arthritis

Sternoclavicular Joint Septic Arthritis