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[Reactive arthritis induced by Clostridium difficile enteritis].

P Guillemin1, J C Gerster

  • 1Service de Rhumatologie, Médecine Physique et Réhabilitation, CHUV, Lausanne.

Praxis
|April 26, 2005
PubMed
Summary

This case study highlights reactive arthritis in a HLA-B27 positive female following Clostridium difficile colitis. Prompt diagnosis and metronidazole treatment led to a favorable outcome.

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Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Microbiology

Background:

  • Reactive arthritis is a form of inflammatory arthropathy.
  • It is associated with the human leukocyte antigen (HLA) B27.
  • Clostridium difficile infection can be a trigger for reactive arthritis.

Observation:

  • A female patient, positive for HLA-B27, presented with acute ankle monoarthritis, diarrhea, and fever.
  • She had a history of antibiotic treatment, suggesting Clostridium difficile colitis.
  • Synovial fluid cultures were sterile, indicating a non-infectious arthritis etiology.

Findings:

  • The patient's condition was diagnosed as reactive arthritis secondary to Clostridium difficile colitis.
  • Diagnosis was confirmed by detecting toxins A and B in stool samples and a positive stool culture.
  • The patient responded well to metronidazole therapy.

Implications:

  • This case underscores the importance of considering Clostridium difficile infection in the differential diagnosis of reactive arthritis, especially in HLA-B27 positive individuals.
  • Early identification and appropriate antibiotic treatment are crucial for managing this condition.
  • The findings contribute to understanding the spectrum of post-infectious arthropathies.

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