A Case of Septic Arthritis due to Haemophilus influenzae associated with Atypical Kawasaki Disease

ABSTRACT

We report a case of septic arthritis due to H. influenzae associated with atypical Kawasaki disease. A 2-year-old boy was admitted to our orthopedic department due to limping gait of the right leg. CT finding of right hip joint revealed fluid collection. He was diagnosed as transient synovitis and septic arthritis. He was treated with antibiotics, but no incision nor drainage was performed. During the antibiotics therapy, limping gait subsided, but high fever, skin rash and lip fissure developed. Echocardiographic finding showed both coronary artery aneurysms. We diagnosed the boy's condition as atypical Kawasaki disease, and treated it with intravenous immunoglobulin(IVIG) and aspirin. Even, with the use of IVIG, fever was persistent. A second IVIG was tried, but fever did not subside. An MRI of right hip joint was followed up. The finding was consistent with septic arthritis associated with osteomyelitis of the right femur head. An incision and drainage was performed on the right hip joint, and the pus culture revealed beta-lactamase negative H. influenzae.