Septic arthritis in an HIV-positive hemophiliac

Despite the high frequency of bacterial infections in HIV-positive patients, septic arthritis is rare, but it is increasing in HIV-positive hemophiliacs. We describe an HIV-positive male hemophilic, aged 38, with septic arthritis who was treated unsuccessfully with antibiotics for 4 days. Synovial fluid was then aspirated and from the culture grew Salmonella (Group D). He was treated according to the in-vitro sensitivity of the organism and gradually improved. It is important to include septic arthritis in the differential diagnosis of HIV-positive hemophiliacs with arthritis and fever. Synovial fluid should be cultured early in the course of the disease to isolate the pathogen so that antibiotic therapy can be started in accordance with in-vitro sensitivity.