Bone and Joint Complications of Hemophilus influenzae Meningitis

Abstract

Seven patients with a bone or joint complications were identified among 202 cases treated for Hemophilus influenzae meningitis between 1970 and 1980. All patients studied met the min imal diagnostic criteria of pleocytosis of the cerebrospinal fluid (CSF) and CSF culture positive for H. influenzae. The diagnosis of bone or joint complication was based on objective findings of physical examination: swelling, erythema and decreased range of motion, and either an increased number of granulocytes in aspirated joint fluid or radiographic and/or radionuclide scan evidence of bone or joint disease. The only significant difference between the control patients and those with bone or joint complications was duration of fever; in the control group 29 per cent of patients were febrile seven or more days, compared with 100 per cent of com plication group. Since a number of those patients who remain febrile beyond the sixth hospital day had presumptive evidence or bone or joint infection, we suggest a bone scan be considered for these patients.