Related Experiment Videos
Reactive arthritis after an outbreak of Yersinia pseudotuberculosis serotype O:3 infection
T Hannu1, L Mattila, J P Nuorti
1Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital, Finland.
Objective:
To determine the occurrence and clinical characteristics of reactive arthritis (ReA) after an outbreak of Yersinia pseudotuberculosis serotype O:3 infection.
Methods:
From 15 October to 6 November 1998, a widespread outbreak of Y pseudotuberculosis serotype O:3 occurred in Finland. A questionnaire on musculoskeletal symptoms was mailed to 38 patients with infection confirmed by culture. All patients who reported joint symptoms were interviewed by phone and their medical records of outpatient visits or hospital admission because of recent joint symptoms were reviewed.
Results:
Thirty three of 38 (87%) patients returned the questionnaire. Reactive musculoskeletal symptoms were reported by 5/33 (15%): four patients (12%) fulfilled the criteria for ReA and one additional patient had reactive enthesopathy. The patients with ReA were adults (age range 40-47 years), whereas the patient with reactive enthesopathy was a 14 year old boy. In all patients with ReA, the arthritis was polyarticular. In addition to peripheral arthritis, other musculoskeletal symptoms included sacroiliitis (one patient), pain in Achilles tendon (one patient), and heel pain (two patients). HLA-B27 was positive in all the three patients tested. In three of four patients with ReA, the duration of acute arthritis was over six months.
Conclusion:
Y pseudotuberculosis serotype O:3 infection is frequently associated with ReA and the clinical picture is severe.
Insights
Yersinia pseudotuberculosis serotype O:3 infection can lead to reactive arthritis (ReA), a severe condition. This study investigated the occurrence and characteristics of ReA following a 1998 outbreak in Finland.
Area of Science:
- Rheumatology
- Infectious Diseases
- Epidemiology
Background:
- Reactive arthritis (ReA) is a form of inflammatory arthritis that occurs following an infection elsewhere in the body.
- Yersinia pseudotuberculosis is a bacterial pathogen that can cause gastrointestinal illness and has been linked to reactive arthritis.
Purpose of the Study:
- To determine the incidence and clinical presentation of reactive arthritis (ReA) subsequent to an outbreak of Yersinia pseudotuberculosis serotype O:3 infection.
- To characterize the spectrum of musculoskeletal manifestations associated with Yersinia pseudotuberculosis serotype O:3 infection.
Main Methods:
- A questionnaire survey was distributed to 38 patients with culture-confirmed Yersinia pseudotuberculosis serotype O:3 infection during a 1998 outbreak in Finland.
- Patients reporting musculoskeletal symptoms underwent phone interviews and medical record reviews to assess for reactive arthritis and related conditions.
- Diagnostic criteria for ReA were applied, and clinical features including joint involvement, extra-articular manifestations, and HLA-B27 status were documented.
Main Results:
- Of 33 respondents, 15% reported reactive musculoskeletal symptoms, with 12% meeting the criteria for ReA.
- ReA patients were adults (40-47 years), experiencing polyarticular arthritis, with one case also showing sacroiliitis.
- Reactive enthesopathy was observed in a 14-year-old boy. HLA-B27 positivity was noted in all tested ReA patients, and arthritis duration exceeded six months in most cases.
Conclusions:
- Yersinia pseudotuberculosis serotype O:3 infection is a significant trigger for reactive arthritis.
- The clinical presentation of ReA following this infection can be severe and prolonged, characterized by polyarticular involvement and potential enthesitis.