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Clinical picture of reactive salmonella arthritis
1Second Department of Medicine, Helsinki University Central Hospital, Finland.
Abstract:
Twenty-three patients with reactive salmonella arthritis were treated at the Departments of Medicine (in 1970-1984) or at the Outpatient Department (in 1980-1986) of Meilahti Hospital. Nine different salmonella species were implicated as triggering factors. Salmonella was detected in 74% of the patients by stool cultures. Widal test was positive (greater than or equal to 1:160) in the remainder. The acute clinical picture was that of oligo or polyarthritis. Other musculoskeletal and inflammatory symptoms were frequent. The mean duration of the acute arthritis was 4.7 months (range 1.5-6.0). In 4 patients the disease ran a chronic course. The treatment of salmonella infection with chemotherapy had no obvious effect on the duration of the arthritis. In conclusion, salmonella arthritis is a form of seronegative spondyloarthritis, with acute features common to other types of reactive arthritides. The search for Salmonella should be included in the study of a patient with acute arthritis. Serology can be of help in patients with negative bacterial cultures.
Insights
Salmonella arthritis, a type of reactive arthritis, often presents acutely with joint inflammation. Early detection of Salmonella through stool cultures or serology is crucial for diagnosis and management.
Area of Science:
- Rheumatology
- Infectious Diseases
- Microbiology
Background:
- Reactive arthritis is a significant cause of joint inflammation.
- Salmonella species are recognized triggers for reactive arthritis.
- Understanding the clinical course and diagnostic markers is essential for patient care.
Purpose of the Study:
- To characterize the clinical presentation and course of salmonella-induced reactive arthritis.
- To evaluate the diagnostic utility of stool cultures and serological tests in salmonella arthritis.
- To assess the impact of chemotherapy on the duration of salmonella arthritis.
Main Methods:
- Retrospective analysis of 23 patients with reactive salmonella arthritis.
- Identification of Salmonella species from stool cultures.
- Assessment of Widal test results for serological diagnosis.
- Clinical observation of arthritis duration and course.
Main Results:
- Nine Salmonella species were identified as causative agents.
- Salmonella was detected in 74% of patients via stool culture; Widal test was positive in the remainder.
- The mean duration of acute arthritis was 4.7 months, with 4 cases progressing to a chronic course.
- Chemotherapy for Salmonella infection showed no clear effect on arthritis duration.
Conclusions:
- Salmonella arthritis is a seronegative spondyloarthritis with features common to other reactive arthritides.
- Investigating Salmonella is recommended for patients presenting with acute arthritis.
- Serological testing aids diagnosis in cases with negative bacterial cultures.