LONG-TERM EVALUATION OF SEPTIC ARTHRITIS IN HEMOPHILIC PATIENTS

Before 1983, septic arthritis was rare in patients with hemophilia. Wi th the advent of human immunodeficieney virus infection in the hemophi lia population, many centers noted an increasing incidence of patients with septic arthritis, Fifteen septic joints in 10 patients with seve re hemophilia were documented, Eight patients were human immunodeficie ncy virus positive, 1 was human immunodeficiency virus negative, and 1 was not tested, The diagnosis was delayed in 5 patients because the s ymptoms are similar to an acute hemarthrosis, An elevated temperature was common, The white blood cell count was elevated in only 1/3 of the infections, being modified by human immunodeficiency virus infection, Associated risk factors included infected angioaccess catheters (2), pneumonia (2), and generalized sepsis (1), All but 1 joint responded t o appropriate antibiotics and either repeated aspiration or arthrotomy , However, 6 patients died of acquired immunodeficiency syndrome from 2 to 109 months after infection, Three patients are alive 29, 86, and 96 months, respectively, after infection.