Haemophilus influenzae type b osteomyelitis
D. M. Granoff, E. Sargent and D. Jolivette
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.
