Haemophilus parainfluenzae osteomyelitis as initial manifestation of an infectious endocarditis

Haemophiltus parainfluenzae seldom causes human infections. It has been isolated in clinical specimens of patients with pneumonia, meningitis and endocarditis but rarely in bone or joint infections. We present a 62 years old man with an intense pain in his neck and left shoulder. Two sets of blood cultures were positive for Haemophilus parainfluenzae. Bone scan and CT suggested a septic process in the clinically affected areas. Posterior evolution confirmed the presence of an underlying infectious endocarditis. Ampicillin first and ciprofloxacin afterwards were the antibiotic, treatments. This quinolone has a good penetration into the bone and, as an oral treatment, it can be a good alternative for osteoarticular infections in outpatients, However, controversy exists about its efficacy when infectious endocarditis is suspected.