Indomethacin and Occult Infections

To the Editor.—  I recently read the article by Joe G. Hardin, MD (240:1889,1978), in which he described a man with long-standing Still's disease and a Proteus mirabilis arthritis of the hip. Despite appropriate antibiotic therapy and no symptoms suggestive of a continued pyarthrosis, he still had the same organism in the hip six months later at the time of a successful joint replacement. Hardin stated that this patient, who was receiving indomethacin therapy for rheumatoid arthritis, showed no gross signs of infection at surgery. Furthermore, the patient had been clinically well, experiencing only a degree of hip pain compatible with mechanical joint dysfunction. Hardin believed that a Gram-negative bacillary arthritis of this duration, with these few clinical expressions and relatively benign histopathologic signs, had not, to his knowledge, been previously recognized. He hypothesized that this patient's course might be peculiar to infection with P mirabilis and suggested that in