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A case of reactive arthritis due to Clostridium difficile colitis

Reactive arthritis is an acute, aseptic, inflammatory arthropathy following an infectious process but removed from the site of primary infection. It is often attributed to genitourinary and enteric pathogens, such as Chlamydia, Salmonella, Shigella, Campylobacter, and Yersinia, in susceptible indivi...

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Autores principales: Essenmacher, Alex C., Khurram, Nazish, Bismack, Gregory T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Co-Action Publishing 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4763550/
https://www.ncbi.nlm.nih.gov/pubmed/26908381
http://dx.doi.org/10.3402/jchimp.v6.30151
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author Essenmacher, Alex C.
Khurram, Nazish
Bismack, Gregory T.
author_facet Essenmacher, Alex C.
Khurram, Nazish
Bismack, Gregory T.
author_sort Essenmacher, Alex C.
collection PubMed
description Reactive arthritis is an acute, aseptic, inflammatory arthropathy following an infectious process but removed from the site of primary infection. It is often attributed to genitourinary and enteric pathogens, such as Chlamydia, Salmonella, Shigella, Campylobacter, and Yersinia, in susceptible individuals. An uncommon and less recognized cause of this disease is preceding colonic infection with Clostridium difficile, an organism associated with pseudomembranous colitis and diarrhea in hospitalized patients and those recently exposed to antibiotics. Recognition of this association may be complicated by non-specific presentation of diarrhea, the interval between gastrointestinal and arthritic symptoms, and the wide differential in mono- and oligoarthritis. We present the case of a 61-year-old, hospitalized patient recently treated for C. difficile colitis who developed sudden, non-traumatic, right knee pain and swelling. Physical examination and radiographs disclosed joint effusion, and sterile aspiration produced cloudy fluid with predominant neutrophils and no growth on cultures. Diagnostic accuracy is enhanced by contemporaneous laboratory investigations excluding other entities such as gout and rheumatoid arthritis and other infections that typically precede reactive arthritis. Contribution of Clostridium infection to reactive arthritis is an obscure association frequently difficult to prove, but this organism is warranted inclusion in the differential of reactive arthritis.
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spelling pubmed-47635502016-03-09 A case of reactive arthritis due to Clostridium difficile colitis Essenmacher, Alex C. Khurram, Nazish Bismack, Gregory T. J Community Hosp Intern Med Perspect Case Report Reactive arthritis is an acute, aseptic, inflammatory arthropathy following an infectious process but removed from the site of primary infection. It is often attributed to genitourinary and enteric pathogens, such as Chlamydia, Salmonella, Shigella, Campylobacter, and Yersinia, in susceptible individuals. An uncommon and less recognized cause of this disease is preceding colonic infection with Clostridium difficile, an organism associated with pseudomembranous colitis and diarrhea in hospitalized patients and those recently exposed to antibiotics. Recognition of this association may be complicated by non-specific presentation of diarrhea, the interval between gastrointestinal and arthritic symptoms, and the wide differential in mono- and oligoarthritis. We present the case of a 61-year-old, hospitalized patient recently treated for C. difficile colitis who developed sudden, non-traumatic, right knee pain and swelling. Physical examination and radiographs disclosed joint effusion, and sterile aspiration produced cloudy fluid with predominant neutrophils and no growth on cultures. Diagnostic accuracy is enhanced by contemporaneous laboratory investigations excluding other entities such as gout and rheumatoid arthritis and other infections that typically precede reactive arthritis. Contribution of Clostridium infection to reactive arthritis is an obscure association frequently difficult to prove, but this organism is warranted inclusion in the differential of reactive arthritis. Co-Action Publishing 2016-02-17 /pmc/articles/PMC4763550/ /pubmed/26908381 http://dx.doi.org/10.3402/jchimp.v6.30151 Text en © 2016 Alex C. Essenmacher et al. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Essenmacher, Alex C.
Khurram, Nazish
Bismack, Gregory T.
A case of reactive arthritis due to Clostridium difficile colitis
title A case of reactive arthritis due to Clostridium difficile colitis
title_full A case of reactive arthritis due to Clostridium difficile colitis
title_fullStr A case of reactive arthritis due to Clostridium difficile colitis
title_full_unstemmed A case of reactive arthritis due to Clostridium difficile colitis
title_short A case of reactive arthritis due to Clostridium difficile colitis
title_sort case of reactive arthritis due to clostridium difficile colitis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4763550/
https://www.ncbi.nlm.nih.gov/pubmed/26908381
http://dx.doi.org/10.3402/jchimp.v6.30151
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