Clostridium difficile associated reactive arthritis: Case report and literature review

Legendre, Paul; Lalande, V.; Eckert, Catherine; Barbut, Frédéric; Fardet, L.; Meynard, Jean-Luc; Surgers, Laure

doi:10.1016/j.anaerobe.2015.12.011

Cited by 17 publications

(6 citation statements)

References 47 publications

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“…It has been observed that C. difficile testing from stool is negative in more than 50% of extra-colonic CDIs, which has been thought to be due to the inability of the standardized clinical method of detection to detect a very low bacterial load that is mostly colonizing the colon; the possible detection of C. difficile from samples taken from the skin and environment around patients with extra-colonic CDI supports this hypothesis [10] . Other extra-colonic presentations related to CDI but not due to the bacterium itself include reactive arthritis or haemolytic-uraemic syndrome, which has been attributed to interruption of immunological tolerance during antigen presentation, especially in patients with underlying HLA-B27 status [11] .…”

Section: Discussionmentioning

confidence: 99%

Clostridioides difficile Bacteraemia and Septic Arthritis in a Sickle Cell Disease Patient

Alqurashi

Madani

Mursi

et al. 2022

European Journal of Case Reports in Internal Medicine

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Section: Discussionmentioning

confidence: 99%

Clostridioides difficile Bacteraemia and Septic Arthritis in a Sickle Cell Disease Patient

Alqurashi

Madani

Mursi

et al. 2022

European Journal of Case Reports in Internal Medicine

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“…It usually develops 10 days after the CDI, and its initial presentation is a monoarthritis or oligoarthritis, most frequently involving the ankles and knees. The criteria for diagnosing a reactive arthritis associated with CDI include: (i) evidence of aseptic synovitis developing during or immediately after colitis; (ii) presence of toxin in stool samples; and (iii) absence of other causes [ 5 ]. Based on the initial presentation, which fitted all these criteria, our first hypothesis was that of a reactive arthritis.…”

Section: Discussionmentioning

confidence: 99%

Hypertrophic osteoarthropathy mimicking a reactive arthritis: a case report and review of the literature

Bozzao

Bernardi

Dore

et al. 2018

BMC Musculoskelet Disord

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BackgroundHypertrophic osteoarthropathy (HOA) is a syndrome characterized by abnormal proliferation of skin and periosteal tissues of the extremities. It can be a rare hereditary disease (pachydermoperiostosis) or can be secondary to various diseases, though mostly lung malignancies. Here, we report an unusual clinical presentation of HOA.Case presentationA 77-year-old man presented with fever, diarrhea, and an oligoarthritis involving the left knee and the ankles. Since left knee synovial fluid aspiration revealed an aseptic synovitis and Clostridium Difficile toxin was detectable in stool samples, a reactive arthritis secondary to a Clostridium Difficile induced colitis was initially suspected. However, the presence of a worsened digital clubbing and the lack of a good clinical response to steroid therapy led us to perform a radionuclide bone scanning, which revealed HOA. This turned out to be associated with a lepidic predominant lung adenocarcinoma, which was clinically and radiologically difficult to distinguish from a relapse of pneumonia.ConclusionConsistent with the literature, HOA tends to have a variable clinical presentation, mimicking that of various rheumatic diseases. This clinical case shows that HOA can present as a presumptive acute reactive arthritis, and it highlights the importance of patient’s follow-up in the differential diagnosis of inflammatory arthritis, especially when a worsened digital clubbing is present.

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“…B. Clostridium difficile, Calmette-Guerin-Bacillus, C.pn. und Mycoplasma pneumoniae nicht berücksichtigt sind, die wegen der Häufigkeit des HLA-B27 ebenfalls als Erreger der HLA-B27-assoziierten ReA zugeordneten werden müssen [26][27][28][29]. Entsprechend unvollständig und nicht mehr auf dem neuesten Forschungsstand sind evidenzbasierte Vorschläge zur Diagnostik [30,31].…”

Section: Diagnose-und Klassifikationskriterienunclassified

Geschichte der reaktiven Arthritis. Historische Meilensteine und Zukunft

Zeidler

2022

Z Rheumatol

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QR-Code scannen & Beitrag online lesen ZusammenfassungDie Einführung der Bezeichnung reaktive Arthritis (ReA) für die nach Infektion mit Yersinia enterocolitica beobachtete Gelenkentzündung, bei der "ein ursächlicher Erreger nicht aus der Gelenkflüssigkeit isoliert werden kann", und die Assoziation mit dem HLA-B27 waren die historischen Wegmarken für eine neue Klassifikation und Zuordnung zu den Spondyloarthritiden (SpA). Die 1976 vorgeschlagene Unterteilung in postinfektiöse und reaktive Arthritiden erfuhr in den 1990er-Jahren durch Untersuchungen mit der neu verfügbaren molekularbiologischen Methode der Polymerasekettenreaktion eine Relativierung. Aus Gelenkproben von Patienten mit ReA konnten mikrobielle Produkte identifiziert werden. Deshalb wurde vorgeschlagen, die Unterscheidung zwischen den beiden Erkrankungsgruppen aufzugeben und für beide den Begriff "ReA" vorzuziehen. Daraus ist eine terminologische und nosologische Problematik entstanden. Einerseits existieren Klassifikations-und Diagnosekriterien für die klassische HLA-B27-assoziierte ReA, die der SpA zugeordnet und allgemein akzeptiert sind. Andererseits sind eine zunehmende Zahl von bakteriellen Erregern, Viren, Amöben, Helminthen, aber auch antivirale und antibakterielle Impfungen als Auslöser einer Arthritis beschrieben, die unter der Bezeichnung ReA publiziert wurden. Seit dem Beginn der SARS-CoV-2-Pandemie werden Fälle einer akuten Post-COVID-19-Arthritis beschrieben, die wegen der vergleichbaren klinischen Merkmale ebenfalls als ReA klassifiziert wurden. SchlüsselwörterPostinfektiöse Arthritis • Post-COVID-19-Arthritis • Sexually acquired reactive arthritis • Antibiotische Kombinationstherapie • Biologika Einteilung der durch eine Infektion verursachten Arthritiden in infektiös, postinfektiös und reaktiv Keat et al. 1987

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Clostridium difficile associated reactive arthritis: Case report and literature review

Abstract: ReA-CDI remains uncommon. Compared to the general population, it is more likely observed in younger patients with HLA B27-positive genotype.

Cited by 17 publications

References 47 publications

Clostridioides difficile Bacteraemia and Septic Arthritis in a Sickle Cell Disease Patient

Clostridioides difficile Bacteraemia and Septic Arthritis in a Sickle Cell Disease Patient

Hypertrophic osteoarthropathy mimicking a reactive arthritis: a case report and review of the literature

Geschichte der reaktiven Arthritis. Historische Meilensteine und Zukunft

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