Septic Arthritis in Children With Hemophilia

Four of the 139 children with hemophilia followed up at our center have developed septic arthritis during the past 6 years (2.9% incidence). Two infections were caused by Streptococcus pneumoniae and one each by staphylococcus aureus and Haemophilus influenzae type B. Common features at time of presentation included fever and a 2- to 7-day history of joint pain and swelling unresponsive to factor replacement infusions. Since three of the patients were human immunodeficiency virus seropositive, we propose that human immunodeficiency virus infection may be responsible for the disproportionately high number of cases of septic arthritis observed in our patient population.