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Query: UMLS:C0348321 (Haemophilus)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A survey of 158 children with acute haematogenous osteomyelitis, and of 94 children with acute septic arthritis over an 8-year period was made to determine which bacteria cause these infections. In the osteomyelitis group the organism most frequently detected was Staphylococcus aureus (74% of cases). In 16% of cases streptococci were found. Staph. aureus was also the most frequently grown organism in cases of acute septic arthritis (55% of cases), but Haemophilus influenzae accounted for 24% of positive cultures. On the basis of the survey it is the current practice of the author to use a combination of methicillin or cloxacillin and penicillin for acute haematogenous osteomyelitis, and methicilline or cloxacillin and ampicillin for acute septic arthritis. The choice of antibiotics is vitally important as treatment must start before the results of culture are known. Repeated evaluation of trends in the pattern of causative organisms is strongly recommended, in order to be aware of changing sensitivity of organisms to antibiotics.
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PMID:Choice of antibiotics in management of acute osteomyelitis and acute septic arthritis in children. 30

Three children had osteomyelitis due to Haemophilus influenzae type b. They were seen with signs and symptoms indistinguishable from infection caused by other organisms. One child was initially misdiagnosed as having septic arthritis because of failure to appreciate that Hemophilus may also cause bone infection. In the second patient osteomyelitis and arthritis developed during ampicillin sodium therapy for treatment of Hemophilus meningitis. His initial infection was caused by an ampicillin-sensitive isolate but his orthopedic infection subsequently responded to therapy only after changing to a regimen of chloramphenicol. In the third patient, bone scintigraphy was helpful in diagnosis since serial roentgenograms were not diagnostic of osteomyelitis. The anticapsular antibody responses of these patients were measured by radioimmune assay. The levels found were low but comparable to age-matched control children with H influenzae type b meningitis.
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PMID:Haemophilus influenzae type b osteomyelitis. 30 93

Haemophilus influenzae is an aerobic pleomorphic gram-negative coccobacillus that requires both X and V factors for growth. It grows poorly, if at all, on ordinary blood agar unless streaked with Staph. aureus. It grows well on chocolate agar. Because this medium is often not used in culturing specimens from adults and because the organism may be overgrown by other bacteria, the frequency of H. influenzae infections has undoubtedly been seriously underestimated. This is aggravated by the failure of many physicians to obtain blood cultures in suspected bacterial infections and the failure of many laboratories to subculture them routinely onto chocolate agar. H. influenzae, along with Streptococcus pneumoniae, is a major factor in acute sinusitis. It is probably the most frequent etiologic agent of acute epiglottitis. It is probably a common, but commonly unrecognized, cause of bacterial pneumonia, where it has a distinctive appearance on Gram stain. It is unusual in adult meningitis, but should particularly be considered in alcoholics; in those with recent or remote head trauma, especially with cerebrospinal fluid rhinorrhea; in patients with splenectomies and those with primary or secondary hypogammaglobulinemia. It may rarely cause a wide variety of other infections in adults, including purulent pericarditis, endocarditis, septic arthritis, obstetrical and gynecologic infections, urinary and biliary tract infections, and cellulitis. Antimicrobial susceptibility testing is somewhat capricious in part from the marked effect of inoculum size in some circumstances. In vitro and in vivo results support the use of ampicillin, unless the organism produces beta-lactamase. Alternatives in minor infections include tetracycline, erythromycin, and sulfamethoxazole-trimethoprim. For serious infections chloramphenicol is the best choice if the organism is ampicillin-resistant or the patient is penicillin-allergic.
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PMID:Haemophilus influenzae infections in adults: report of nine cases and a review of the literature. 31 Sep 43

In the first 4 years (1974 to 1978) of operation of the Children's Hospital of Eastern Ontario, in Ottawa, 50 children were treated for septic arthritis. The neonatal group (birth to 6 months) of three patients had the most severe involvement and the worst prognosis. The early childhood group (6 months to 4 years) of 15 patients was characterized by sepsis due to Hemophilus influenzae. The 32 older children (4 to 16 years), more susceptible to staphylococcal infections, commonly presented with atypical and unusual symptoms. The erythrocyte sedimentation rate was the most reliable laboratory investigation. Positive joint cultures were obtained in 66% of patients. Arthrotomy with drainage was the most reliable form of treatment, particularly in cases of hip joint sepsis. Six patients have substantial residual joint damage with some degree of permanent disability. Early diagnosis of the condition and rapid removal of pus are mandatory for the survival of the joint.
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PMID:Septic arthritis in childhood. 31 36

Thirty-eight children (39 hips) with septic arthritis have been reviewed in an effort to determine the factors most important to prognosis of the hip joint. The younger patients, 3 or more years later, had poorer results by roentgenographic classification. This was particularly true of patients under one year of age. Longer duration of disease from clinical onset to initiation of therapy also resulted in a poorer result. The outcome could not be clearly correlated with the causative organism or with open as opposed to closed treatment although the policy of management was strongly biased to open drainage. Sixty per cent of the infections were caused by Staphylococcus aureaus and the majority of the other cases by Streptococcus pyogenes and Hemophilus influenzae. The nonstaphylococcal organisms may be less destructive to the femoral head in infants.
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PMID:Prognosis in septic arthritis of the hip in children. 45 55

Septic arthritis affects weight-bearing joints in three fourths of cases. When the disease occurs in infancy, joint dysfunction may not be apparent until many months later. We located 49 children who had had 50 episodes of septic arthritis from 1 1/2 to 12 years earlier (mean, 4.3 years). Thirteen patients (27%) had sequelae, and in eight (16%), there was impairment of ambulation. Residual damage was more common with hip and ankle involvement than with knee joint disease. Sequelae were equally common after Haemophilus influenzae and Staphylococcus aureus infection. Evaluation at the time of hosiptal discharge correctly identified only four of the 13 children with sequelae, and four others who were normal at follow-up had been thought to have permanent damage at discharge. Children with sequelae tended to have been sick longer before diagnosis, and drainage of pus was delayed.
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PMID:Residual effects of septic arthritis in infancy and childhood. 98 90

A prospective study of one hundred children with septic arthritis showed that the knee and hip were the joints most affected and that Staphylococcus aureus and Haemophilus influenzae Type B were the commonest bacteria grown. Our treatment, consisting of early arthrotomy and intravenous methicillin and ampicillin, followed by six weeks of joint immobilization and oral administration of cloxacillin and ampicillin, effectively reversed the inflammatory process and compared very favourably with other methods of treatment. Significant residual joint abnormalities, present in 7% of the children, resulted from severe joint damage occurring before treatment. To achieve the best results, this regime must be instituted before permanent joint damage has occurred. This will only be achieved if an early clinical diagnosis of septic arthritis is made.
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PMID:The management of septic arthritis in childhood. 108 90

For better definition of the clinical course and outcome of children with occult bacteremia caused by Haemophilus influenzae type b (Hib), we reviewed the medical records of children who were initially managed as outpatients and subsequently found to be bacteremic. At Yale-New Haven Hospital (1971 to 1987) and the Children's Hospital of Philadelphia (1982 to 1987), 69 previously healthy children were identified with occult Hib bacteremia. Their median age was 14 months (range, 4 to 89 months). Thirty-six (52%) of the 69 were either febrile and/or had a focus of serious infection at follow-up (meningitis (17), pneumonia (5), epiglottitis (3), cellulitis (5), and septic arthritis (3)). Although the remaining 33 children (48%) were afebrile and appeared well on reevaluation, 3 of these 33 were still bacteremic and another 5 subsequently developed focal Hib infections. These 8 children were significantly younger (median age, 8.5 months) than the 25 children who remained well (median age, 16 months; P = 0.03). Of the 28 children who had initially been treated with antimicrobials to which their organism was known to be susceptible, 12 (43%) were improved at reevaluation and remained well; 7 (23%) of the 31 patients who had not received such antimicrobials improved and remained well (P = 0.17). Children initially managed as outpatients and later found to have had Hib bacteremia are at risk of subsequently developing a serious focal infection.
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PMID:Outcome of children with occult bacteremia caused by Haemophilus influenzae type b. 152 40

A 4-year-old girl with Legg-Calve Perthes' disease and immunoglobin G1 subclass deficiency developed osteomyelitis of the proximal femur and septic arthritis of the hip secondary to Haemophilus influenzae, type f. This microorganism is a rare cause of invasive infections in children, primarily of the central nervous system (CNS) and respiratory track. It has not previously been associated with bone and joint infections.
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PMID:Osteomyelitis and septic arthritis caused by Haemophilus influenzae, type f, in a young girl. 157 41

Haemophilus influenzae is a rare cause of septic arthritis in adults. We describe a case of septic arthritis with nontypable Haemophilus influenzae presenting as the first invasive infection leading to a diagnosis of common variable hypogammaglobulinemia. Although nontypable strains have been shown to cause serious infections in adults, they are a rare cause of septic arthritis. Underlying immune deficiency should be considered in an adult who presents with invasive infection with Haemophilus influenzae, regardless of serotype.
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PMID:Common variable hypogammaglobulinemia presenting as nontypable Haemophilus influenzae septic arthritis in an adult. 186 31


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