# Haemophilus influenzae Bacteremia With Polyarthritis and Uterine Fibroids in a 31-Year-Old Woman: A Case Report

## TL;DR

A 31-year-old woman presented with joint pain and other symptoms, later diagnosed with rare H. influenzae bacteremia, possibly linked to reproductive tract issues.

## Contribution

This case report highlights an atypical presentation of H. influenzae bacteremia with polyarthritis and uterine fibroids.

## Key findings

- The patient exhibited polyarticular pain, fever, and systemic symptoms, with H. influenzae confirmed in blood cultures.
- Imaging revealed uterine fibroids and an ovarian cyst, suggesting a possible source of infection.
- The case illustrates diagnostic challenges when H. influenzae presents outside the respiratory tract.

## Abstract

Haemophilus influenzae (H. influenzae) can, in rare cases, infect the female reproductive tract, typically presenting with fever, lower abdominal pain, and vaginal discharge. Rarely, infection manifests with diffuse polyarticular pain and systemic symptoms. We report the case of a woman in her early 30s who presented to the emergency department (ED) with a two-day history of polyarticular joint pain, malaise, chills, and weakness. Examination revealed tachycardia and tenderness of multiple joints on passive and active range of motion. Laboratory evaluation showed leukocytosis, elevated C-reactive protein (CRP), elevated troponin, iron-deficiency anemia, and a positive urinalysis. Despite persistent polyarticular pain, the patient developed worsening lower abdominal pain, chest pain, and progressive lower extremity weakness. Blood cultures grew H. influenzae, confirming bacteremia. Imaging revealed a large intramural fibroid causing mass effect and a right ovarian cyst. Pelvic examination demonstrated a friable, elongated cervix, though vaginal fluid culture and Gram stain were negative. This case highlights an atypical presentation of H. influenzae bacteremia with an unclear primary source, emphasizing the diagnostic challenges posed by extrapulmonary manifestations of this organism.