The British Journal of Rheumatology, Vol 36, 333-337, Copyright © 1997 by British Society for Rheumatology
A Saraux, H Taelman, P Blanche, J Batungwanayo, J Clerinx, A Kagame, L Kabagabo, J Ladner, P Van de Perre, P Le Goff and J Bogaerts
We prospectively studied the demographics, the clinical and diagnostic
features, the HIV-1 serostatus and the therapeutic response for all new
patients with septic arthritis (SA) admitted to the Department of Internal
Medicine of the Centre Hospitalier de Kigali, Rwanda, over a 19 month
period. SA was diagnosed in 24 patients (10 male, 14 female), of whom 19
(79%) were HIV-1 seropositive (HIVpos). Gonococcal arthritis was found in
four patients, all HIVpos. Non-gonococcal bacterial arthritis was
established in 16 patients, of whom 13 were HIVpos. Causative organisms
involved in this group and the corresponding HIV-1 serostatus of the
patients were: Staphylococcus aureus: 4; 2 HIVpos. 2 HIVneg: Streptococcus
pneumoniae: 4; 4 HIVpos; Salmonella group B: 2; 2 HIVpos; Streptococcus
group D: 1; 1 HIVpos; Klebsiella pneumoniae: 1; 1 HIVpos; undetermined: 4;
3 HIVpos; 1 HIVneg. Tuberculous arthritis was presumed in four patients, of
whom two were HIVpos. HIV-1-associated SA had a classical acute
presentation and an overall good prognosis Compared to a control group
consisting of hospitalized patients with malaria as the sole diagnosis,
patients with SA were more likely to be infected with HIV-1 (P = 0.005, or
6.3; 95% CI 1.7 22.2). Prevalence rate estimates of SA among HIVpos and
HIVneg patients were 0.5 and 0.25%, respectively (P = 0.38). We conclude
that HIV-1 infection appears as a risk factor for SA among patients
hospitalized at the Centre Hospitalier de Kigali, but that SA cannot be
used as a predictor for HIV-1 infection for hospitalized patients. SA
occurs infrequently and may present at any stage of HIV-1 infection.
ORIGINAL PAPERS
HIV infection as a risk factor for septic arthritis
Department of Internal Medicine, Centre Hospitalier de Kigali, Rwanda.
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