Clostridium difficile toxin-induced reactive arthritis in a patient with chronic Reiter's syndrome

Cope, Andrew P.; Anderson, Jane; Wilkins, E.G.L.

doi:10.1007/bf01971269

Cited by 21 publications

(8 citation statements)

References 17 publications

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“…to inflamed joints along with other components of gut flora. The latter is more likely in view of the isolation of Campylobacter sequences from patients with diagnoses other that ReA, but it is not inconceivable that a normal member of the gut flora could, under the appropriate circumstances, be involved in triggering ReA; ReA secondary to Clostridium difficile infection falls into this category [22]. …”

Section: Discussionmentioning

confidence: 99%

Investigation of infectious agents associated with arthritis by reverse transcription PCR of bacterial rRNA

2002

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In reactive and postinfectious arthritis the joints are generally sterile but the presence of bacterial antigens and nucleic acids has been reported. To investigate whether organisms traffic to affected joints in these conditions, we performed reverse transcription PCR using universal primers to amplify any bacterial 16S rRNA sequences present in synovial fluid. Bacterial sequences were detected in most cases, even after treatment of the synovial fluid with DNase, implying the presence of bacterial RNA and therefore of transcriptionally active bacteria. Analysis of a large number of sequences revealed that, as reported in rheumatoid arthritis, most were derived from gut and skin commensals. Organisms known to have triggered arthritis in each case were not found by sequencing the products obtained using universal primers, but could in some cases be shown to be present by amplifying with species specific primers. This was the case for Yersinia pseudotuberculosis and Chlamydia trachomatis. However, in arthritis thought to be related to Campylobacter infection the sequences obtained were not from Campylobacter jejuni or C. coli, but from other Campylobacter spp. that are not known to be associated with reactive arthritis and are probably present as commensals in the gut. We conclude that although rRNA from reactive arthritis associated organisms can be detected in affected joints, bacterial RNA from many other bacteria is also present, as was previously noted in studies of other forms of inflammatory arthropathy.

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Section: Discussionmentioning

confidence: 99%

Investigation of infectious agents associated with arthritis by reverse transcription PCR of bacterial rRNA

2002

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“…Organisms associated with Reiter's include Chlamydia trachomatis, 27 Shigella flexneri, 44 Salmonella enteritidis, 45 Salmonella typhimurium, 46 Salmonella muenchen, 47 Yersinia enterocolitica, 48 Y pseudotuberculosis, 49 Campylobacter jejuni and Campylobacter fetus, 50 Ureaplasma urealyticum, 51 and Clostridium difficile. [52][53][54][55][56] Other less commonly associated infections include Neisseria gonorrhoeaa, 57 Borrelia burgdorferi, 58 Chlamydia pneumoniae, 14 and Escherichia coli. 15 The mechanism by which these organisms lead to Reiter's syndrome in some individuals is not clear.…”

Section: Pathophysiology/originmentioning

confidence: 99%

Reiter's syndrome: The classic triad and more

Schwartz²

2008

Journal of the American Academy of Dermatology

164

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“…4 In contrast, a case report by Cope et al, published in 1992, described a case of arthritic symptoms that persisted for several years after the initial episode of arthritis following a diagnosis of C. difficile. 11 Since this was our patient's first incidence of reactive arthritic symptoms, we are unable to further comment on symptom recurrence; however, additional research into this could provide valuable insight to providers in the future. There is also little known data on the duration of arthritic symptoms.…”

Section: Discussionmentioning

confidence: 94%

Reactive arthritis induced by recurrent Clostridium difficile colitis

2012

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Clostridium difficile colitis is a common infection that can be difficult to resolve and may result in recurrent infections. Reactive arthritis is a rare presentation of this disease and its treatment is not well differentiated in the literature. We describe a case of reactive arthritis occurring in a patient with a history of recurrent Clostridium difficile colitis while currently receiving a taper of oral vancomycin. His arthritis symptoms resolved with corticosteroids and continued treatment with anticlostridial antibiotics

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Clostridium difficile toxin-induced reactive arthritis in a patient with chronic Reiter's syndrome

Cited by 21 publications

References 17 publications

Investigation of infectious agents associated with arthritis by reverse transcription PCR of bacterial rRNA

Investigation of infectious agents associated with arthritis by reverse transcription PCR of bacterial rRNA

Reiter's syndrome: The classic triad and more

Reactive arthritis induced by recurrent Clostridium difficile colitis

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