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January 1981

Hemophilia, Maintenance Hemodialysis, and Septic Arthritis

Arch Intern Med. 1981;141(1):138-139. doi:10.1001/archinte.1981.00340010130029

To the Editor.  —Hematogenous septic arthritis is a practically unknown entity among hemophiliacs,1 in spite of their frequent hemarthroses and joint deformities. On the other hand, patients undergoing long-term hemodialysis have been described as having a higher incidence of septic complications, particularly with Staphylococcus aureus.2 We are reporting a case of septic arthritis in a hemophiliac with a long history of joint deformity but without infection, whose first hemarthrosis after beginning dialysis became infected with S aureus.

Report of a Case.  —A 57-year-old man known to have classic hemophilia (factor VIIIc, < 1%) had been under our care for eight years and was rehabilitated from his severe joint deformity with standard physical therapy and factor VIII replacement. He had had an average of six episodes of large joint hemarthroses per year and increasing renal failure resulting from nephrosclerosis and retroperitoneal bleeding. The patient had been in the

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