Septic arthritis is rare in haemophiliacs. Four new cases who were also HIV positive are reported. In three, the knee was involved, and in the fourth the elbow. The organism was streptococcus pneumoniae and staphylococcus aureus in one patient each, and salmonella in two. Although all the patients were human immunodeficiency virus (HIV) positive at the time of diagnosis, only two patients developed autoimmune deficiency syndrome (AIDS) after their septic arthritis. These two died later due to AIDS complications. Treatment was conservative in all cases with antibiotic therapy and prompt rehabilitation. The results were fair in two and good in two. Therefore nonoperative management is advocated before surgical drainage is considered. It seems likely that a positive HIV status is related to the appearance of septic arthritis in haemophiliacs.
R~sum~. L 'arthrite septique est un accident peu frdquent chez les h(mophiles. Les auteurs en prdsentent quatre cas, localis(s au coude chez un patient et au genou chez les trois autres. L 'dtiologie bactdrienne a dtd: un Streptococcus pneumoniae, un
Staphylococcus aureus, et deux Salmonelles. Les quatre malades (taient VIH positifs lots du diagnostic d' arthrite septique; n6anmoins deux d'entre eux seulement ont ddvelopp( un Sida, dont ils sont morts. Le traitement a (t( conservateur clans tous les cas (antibioth6rapie et r(dducation pr(coce). Les rdsultats ont 6t( deux fois moyens et deux fois bons. Les auteurs recommandent de recourir au traitement mddical avant d'envisager un drainage chirurgical.