Reactive arthritis associated with Haemophilus influenzae meningitis

Abstract

We report the case of a seven month old girl who developped reactive arthritis secondary to Haemophilus Influenzae meningitis. During the course of her meningeal picture, she showed arthritis of the metatarso-phalangeal joint of the first left toe, and both hips. It cleared with the antimicrobial therapy applied. On her 13th hospital day when the cerebrospinal fluid was normal, the fever continued and arthritis of the left knee was observed. Aspirin was able to solve this complication, without any further antibiotics. We reviewed the literature that emphasizes the difficulties to distinguish between septic and reactive arthritis, because persistent fever can occur in both conditions. Early onset and positive blood cultures are more common in septic arthritis. Nevertheless no clinical or laborarory data, except the demonstration of the organism in the sinovial fluid, either by Gram stain or by culture, can be used to make a firm differential diagnosis.