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HLA-B27-negative arthritis related to Campylobacter jejuni enteritis in three children and two adults
Insights
Campylobacter jejuni enteritis can lead to arthritis in some patients. Early synovial fluid culture is recommended for arthritis cases following this infection.
Area of Science:
- Gastroenterology
- Rheumatology
- Infectious Diseases
Background:
- Campylobacter jejuni is a common cause of bacterial enteritis.
- Reactive arthritis can occur following enteric infections.
Observation:
- Five of 37 patients with Campylobacter jejuni enteritis developed arthritis.
- Two adults had Reiter's syndrome; one child had reactive arthritis.
- Synovitis resolved within a week, but arthralgia persisted longer in some.
Findings:
- No patients with arthritis were HLA-B27 positive, though 4 others were.
- Campylobacter fetus ssp. jejuni is prevalent in Northern Norway.
- Synovial fluid cultures are advised in arthritis post-enteritis.
Implications:
- Highlights the link between Campylobacter jejuni and joint inflammation.
- Suggests diagnostic importance of synovial fluid cultures.
- Informs clinical suspicion for reactive arthritis in endemic regions.
Abstract:
Five out of 37 patients with proven Campylobacter jejuni enteritis developed arthritis. Two adult patients presented with classical Reiter's syndrome. One of the three children had reactive arthritis, and clinical suspicion of septic arthritis could not be confirmed in two. The acute synovitis subsided usually without treatment in all patients within 3-7 days, while arthralgia persisted longer in 4 patients. HLA-B27 was not present in the 5 patients with arthritis, but was found in 4 others. In Northern Norway, Campylobacter fetus ssp. jejuni is more frequently isolated from stool specimens than Salmonella, Shigella and Yersinia enterocolitica. Synovial fluid should be cultured following Campylobacter jejuni enteritis in arthritis patients.