REVIEW - Arthritis and infections

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Minerva Pediatr. 2005 Aug;57(4):181-8.

[Arthritis and infections]

Cimaz R, Meregalli E, Biggioggero M, Casadei A, Careddu P.

Clinica Pediatrica De Marchi, ICP, Milan.

Arthritis caused by infectious agents can be secondary to direct

invasion of the joint space or to immune mechanisms (subsequent to or

concomitant to an infection). Septic arthritis refers to a situation

when bacteria can be cultured in synovial fluid. Arthritis can

complicate for example meningococcemia or infection by Neisseria

gonorrhoeae or Haemophilus influenzae. Reactive (postinfectious)

arthritides are an important diagnostic category within a pediatric

rheumatology practice. Yersinia and, less frequently, Salmonella, play

an important role in postdiarrheal disorders. The arthritis that can

ensue is usually oligoarticular and occurs 1-2 weeks after the enteric

infection. Reiter's syndrome, rare in the pediatric age, is

characterized by the triad urethritis-conjunctivitis-arthritis.

Postviral arthritides can occur after a variety of viral infections,

including Parvovirus B19, rubella, and others (e.g. hepatitis B,

Epstein-Barr virus, chickenpox, mumps). Especially in patients with

acute arthritis, the presence of preceding infections should always be

investigated. Although the majority of postinfectious arthritides are

self-limiting in nature and do not require specific treatment,

conditions such as Lyme borreliosis and rheumatic fever can be

associated with significant morbidity, and sometimes can be even

lethal.

PMID: 16172597

http://www.ncbi.nlm.nih.gov/pubmed/16172597

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