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Reactive arthritis associated with Clostridium difficile

J McCluskey, T V Riley, E T Owen

    Australian and New Zealand Journal of Medicine
    |October 1, 1982
    PubMed
    Summary
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    Reactive arthritis, a type of joint inflammation, was triggered by Clostridium difficile infection in a patient with a history of Reiter's syndrome. Treatment successfully eliminated the bacteria but joint pain resolution was slow.

    Area of Science:

    • Rheumatology
    • Infectious Diseases
    • Microbiology

    Background:

    • Reactive arthritis is a form of inflammatory arthritis that affects joints.
    • Reiter's syndrome is a condition characterized by arthritis, urethritis, and conjunctivitis.

    Observation:

    • A patient with a history of Reiter's syndrome developed reactive arthritis.
    • Clostridium difficile infection was identified as the likely precipitating agent.
    • High levels of C. difficile toxin were found in fecal samples.

    Findings:

    • Neutralizing antitoxin against C. difficile toxin was present in the patient's serum but absent in synovial fluid.
    • The patient received vancomycin, which successfully eradicated C. difficile.
    • Despite bacterial eradication, the polyarthropathy (joint disease) resolved slowly.

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    Implications:

    • This case highlights a potential link between Clostridium difficile infection and reactive arthritis in individuals with a history of Reiter's syndrome.
    • The findings suggest that C. difficile toxins may play a role in the pathogenesis of reactive arthritis.
    • Further research is warranted to understand the mechanisms involved and optimize treatment strategies for such cases.