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The clinical spectrum of post-streptococcal syndromes with arthritis in children
L Bont1, F Brus, R H Dijkman-Neerincx
1Department of Pediatrics, Rijnstate Hospital, Arnhem, The Netherlands.
Insights
Acute rheumatic fever and post-streptococcal reactive arthritis can follow strep throat. This study details four children with diverse symptoms like arthritis, erythema nodosum, and vasculitis, suggesting a severity-based classification for post-streptococcal syndromes.
Area of Science:
- Rheumatology
- Pediatrics
- Infectious Diseases
Background:
- Streptococcal throat infections are known to cause acute rheumatic fever (ARF) and post-streptococcal reactive arthritis (PSRA).
- Post-streptococcal syndromes encompass a range of conditions following Streptococcus pyogenes infection.
Observation:
- Four pediatric cases presented with arthritis subsequent to a streptococcal throat infection.
- Clinical manifestations varied, including erythema nodosum, livedo reticularis, and cutaneous vasculitis alongside arthritis.
Findings:
- The diverse clinical spectrum of post-streptococcal syndromes necessitates a structured approach.
- Arthritis is a key feature, but other systemic symptoms can co-occur.
Implications:
- A proposed classification system based on disease severity is suggested for post-streptococcal syndromes.
- Tailoring treatment strategies to the specific severity of post-streptococcal conditions is recommended.
Abstract:
Acute rheumatic fever (ARF) and post-streptococcal reactive arthritis (PSRA) are well known complications of streptococcal throat infections. We describe four children with arthritis following a streptococcal throat infection. In addition to arthritis, other clinical manifestations included erythema nodosum, livedo reticularis and cutaneous vasculitis. Because of the very diverse clinical manifestations that may appear after a streptococcal throat infection, we suggest a classification and treatment of post-streptococcal syndromes according to the severity of the disease.