Arthrite réactionnelle a Clostridium difficile

Ducroix-Roubertou, S.; Genet, Corine; Rogez, J.P.; Weinbreck, P.; Denès, E.

doi:10.1016/j.medmal.2005.04.003

Cited by 8 publications

(2 citation statements)

References 3 publications

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“…Encephalopathy attributed to high titers of circulating C. difficile toxins has been proposed ( 17 ). While articular involvement may persist after gastrointestinal symptoms resolve, the long-term prognosis of C. difficile –associated reactive arthritis properly treated with anti-inflammatory drugs seems to be excellent ( 8 , 10 , 18 ).…”

Section: Discussionmentioning

confidence: 99%

A case of reactive arthritis due to Clostridium difficile colitis

Essenmacher

Khurram

Bismack

2016

Journal of Community Hospital Internal Medicine Perspectives

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Reactive arthritis is an acute, aseptic, inflammatory arthropathy following an infectious process but removed from the site of primary infection. It is often attributed to genitourinary and enteric pathogens, such as Chlamydia, Salmonella, Shigella, Campylobacter, and Yersinia, in susceptible individuals. An uncommon and less recognized cause of this disease is preceding colonic infection with Clostridium difficile, an organism associated with pseudomembranous colitis and diarrhea in hospitalized patients and those recently exposed to antibiotics. Recognition of this association may be complicated by non-specific presentation of diarrhea, the interval between gastrointestinal and arthritic symptoms, and the wide differential in mono- and oligoarthritis. We present the case of a 61-year-old, hospitalized patient recently treated for C. difficile colitis who developed sudden, non-traumatic, right knee pain and swelling. Physical examination and radiographs disclosed joint effusion, and sterile aspiration produced cloudy fluid with predominant neutrophils and no growth on cultures. Diagnostic accuracy is enhanced by contemporaneous laboratory investigations excluding other entities such as gout and rheumatoid arthritis and other infections that typically precede reactive arthritis. Contribution of Clostridium infection to reactive arthritis is an obscure association frequently difficult to prove, but this organism is warranted inclusion in the differential of reactive arthritis.

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Section: Discussionmentioning

confidence: 99%

A case of reactive arthritis due to Clostridium difficile colitis

Essenmacher

Khurram

Bismack

2016

Journal of Community Hospital Internal Medicine Perspectives

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“…C. difficile-induced reactive arthritis appears to be associated with HLA-B27 in 66% of patients [31]. Ducroix-Roubertou et al [34] reported a case of a monoarticular arthritis of the left knee following PMC in a 45-year old man, 8 days after the onset of a C. difficile enterocolitis.…”

Section: Extracolonic Featuresmentioning

confidence: 99%

Clostridium difficile infection: clinical spectrum and approach to management

Vaishnavi

2011

Indian J Gastroenterol

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Clostridium difficile is recognized globally as an important enteric pathogen associated with considerable morbidity and mortality due to the widespread use of antibiotics. The overall incidence of C. difficile-associated diarrhea (CDAD) is increasing due to the emergence of a hypervirulent strain known as NAP1/BI/027. C. difficile acquisition by a host can result in a varied spectrum of clinical conditions inclusive of both colonic and extracolonic manifestations. Repeated occurrence of CDAD, manifested by the sudden re-appearance of diarrhea and other symptoms usually within a week of stopping treatment, makes it a difficult clinical problem. C. difficile infection has also been reported to be involved in exacerbation of inflammatory bowel diseases. The first step in the management of a suspected CDAD case is the withdrawal of the offending agent and changing the antibiotic regimens. Antimicrobial therapy directed against C. difficile viz. metronidazole for mild cases and vancomycin for severe cases is needed. For patients with ileus, oral vancomycin with simultaneous intravenous (IV) metronidazole and intracolonic vancomycin may be given. Depending on the severity of disease, the further line of management may include surgery, IV immunoglobulin treatment or high dose of vancomycin. Adjunctive measures used for CDAD are probiotics and prebiotics, fecotherapy, adsorbents and immunoglobulin therapy. Among the new therapies fidaxomicin has recently been approved by the American Food and Drugs Administration for treatment of CDAD.

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Outcomes in Reactive Arthritis

Keat¹,

Hamdulay²

2007

Psoriatic and Reactive Arthritis

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Arthrite réactionnelle a Clostridium difficile

Cited by 8 publications

References 3 publications

A case of reactive arthritis due to Clostridium difficile colitis

A case of reactive arthritis due to Clostridium difficile colitis

Clostridium difficile infection: clinical spectrum and approach to management

Outcomes in Reactive Arthritis

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