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Acute oligoarthritis associated with Clostridium difficile pseudomembranous colitis
Archives of Internal Medicine
|March 1, 1984
Summary
A patient developed sterile inflammatory arthritis alongside Clostridium difficile colitis. Treating the colitis with vancomycin resolved both the colitis and the arthritis, suggesting a link between the two conditions.
Area of Science:
- Rheumatology
- Infectious Diseases
- Gastroenterology
Background:
- Clostridium difficile infection (CDI) can manifest with various extraintestinal symptoms.
- The association between CDI and reactive arthritis, particularly in HLA-B27 positive individuals, is not fully understood.
- Antibiotic-induced colitis can precede or coincide with inflammatory conditions.
Observation:
- A patient presented with acute, sterile inflammatory oligoarthritis affecting the hip and knee.
- Synovial fluid analysis revealed elevated leukocyte counts, indicative of inflammation.
- The patient was positive for the Human Leukocyte Antigen B27 (HLA-B27) marker.
Findings:
- The patient's colitis and arthritis symptoms resolved rapidly following oral vancomycin hydrochloride treatment for Clostridium difficile pseudomembranous colitis.
- Review of three additional cases showed similar arthritis associated with antibiotic-induced colitis.
- Treatment of the underlying colitis appeared to be the key factor in resolving the arthritis.
Implications:
- This case highlights a potential pathogenic link between Clostridium difficile colitis and sterile inflammatory arthritis.
- Effective treatment of CDI may lead to the resolution of associated arthritic symptoms.
- Further research is warranted to elucidate the mechanisms connecting CDI, HLA-B27, and reactive arthritis.