Disseminated tuberculosis associated with reactive arthritis of Poncet in an immunocompetent patient

Calado, Juliana de Oliveira Alves; Miola, Anna Carolina; Silvares, Maria Regina Cavariani; Marques, Sílvio Alencar

doi:10.1016/j.abd.2019.08.031

Cited by 5 publications

(6 citation statements)

References 10 publications

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Section: Discussionmentioning

confidence: 99%

“…Disseminated TB involves at least two extrapulmonary sites, with or without pulmonary involvement, and it is more prevalent in immunocompromised patients [6]. Due to its multiple differential diagnoses [6], it is associated with delayed diagnosis and increased morbidity and mortality of patients. As the skin is a more accessible organ for clinical and histopathological examination, it is important for the dermatologist to understand the various skin-related manifestations of this disease.…”

Section: Discussionmentioning

confidence: 99%

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Dactylitis and Ungual Tuberculosis: An Atypical Presentation of the Disease

Lemos

Horwacz

Baka

et al. 2022

Skin Appendage Disord

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Introduction: Tuberculosis is a common infection caused by Mycobacterium tuberculosis in developing countries. Among the extrapulmonary forms of tuberculosis, cutaneous tuberculosis is rare, and even dermatologists are less familiar with its ungual manifestations. Case Presentation: We present an exuberant case of ungual tuberculosis in a patient with no personal or family history of immunosuppression, which is the first manifestation of the disseminated form of the disease. Conclusion: In our patient, the initial manifestation was related to the nail, probably originating from the progression of bone TB focus, which further progressed with respiratory symptoms and involvement of other organs. We believe this is the first case in which the ungual presentation allowed the diagnosis of disseminated tuberculosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Dactylitis and Ungual Tuberculosis: An Atypical Presentation of the Disease

Lemos

Horwacz

Baka

et al. 2022

Skin Appendage Disord

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“…In the other patient, a diagnosis of atypical seropositive rheumatoid arthritis or pseudo Poncet's disease was established on follow-up. Calado et al recently reported cutaneous tuberculosis, a rare extrapulmonary manifestation of tuberculosis, associated with reactive Poncet arthritis which showed improvement of the clinical and skin condition after appropriate treatment [39]. Lastly, a case report from Japan described a patient with Poncet disease who was successfully treated with a TNF inhibitor after sufficient antitubercular treatment [40].…”

Section: Respiratory Infectionsmentioning

confidence: 99%

Reactive Arthritis Update: Spotlight on New and Rare Infectious Agents Implicated as Pathogens

Zeidler

Hudson

2021

Curr Rheumatol Rep

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Purpose of Review This article presents a comprehensive narrative review of reactive arthritis (ReA) with focus on articles published between 2018 and 2020. We discuss the entire spectrum of microbial agents known to be the main causative agents of ReA, those reported to be rare infective agents, and those reported to be new candidates causing the disease. The discussion is set within the context of changing disease terminology, definition, and classification over time. Further, we include reports that present at least a hint of effective antimicrobial therapy for ReA as documented in case reports or in double-blind controlled studies. Additional information is included on microbial products detected in the joint, as well as on the positivity of HLA-B27. Recent Findings Recent reports of ReA cover several rare causative microorganism such as Neisseria meningitides, Clostridium difficile, Escherichia coli, Hafnia alvei, Blastocytosis, Giardia lamblia, Cryptosporidium, Cyclospora cayetanensis, Entamoeba histolytica/dispar, Strongyloides stercoralis, β-haemolytic Streptococci, Mycobacterium tuberculosis, Mycoplasma pneumoniae, Mycobacterium bovis bacillus Calmette-Guerin, and Rickettsia rickettsii. The most prominent new infectious agents implicated as causative in ReA are Staphylococcus lugdunensis, placenta-and umbilical cord-derived Wharton's jelly, Rothia mucilaginosa, and most importantly the SARS-CoV-2 virus. Summary In view of the increasingly large spectrum of causative agents, diagnostic consideration for the disease must include the entire panel of post-infectious arthritides termed ReA. Diagnostic procedures cannot be restricted to the well-known HLA-B27-associated group of ReA, but must also cover the large number of rare forms of arthritis following infections and vaccinations, as well as those elicited by the newly identified members of the ReA group summarized herein. Inclusion of these newly identified etiologic agents must necessitate increased research into the pathogenic mechanisms variously involved, which will engender important insights for treatment and management of ReA.

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“…1 The entity, first described by Antonin Poncet as polyarthritis associated with tuberculosis, currently is used to describe only cases with reactive arthritis associated with tuberculosis without direct bacteriological confirmation. 2,3 It usually presents as nondestructive arthritis where evidences of bacterial presence are negative following exclusion of other differentials. In contrast to tubercular arthritis directly affecting the joint, PD is usually polyarticular and is found to respond well to anti-tubercular treatment (ATT).…”

Section: Introductionmentioning

confidence: 99%

“…Few other important features that may help differentiate PD from rheumatoid arthritis and other rheumatic conditions (as rheumatoid factor [RA] factor and anti-cyclic citrullinated protein [CCP] can be positive in both cases) and go in favor of PD are reactive arthritis at younger age, arthritic symptoms at initial phase of infection (not weeks after or after infection subsides), dramatic response to ATT (improvements noted in weeks or few months). 3 Very few cases of PD have been reported in the medical literature and many cases, experts believe, might be underreported even from endemic countries. Severe form of PD may result in protracted course with varying morbidity and deformities.…”

Section: Introductionmentioning

confidence: 99%

Poncet′s disease (tubercular rheumatism): a narrative review

Dharmshaktu

2020

Clin Trials Orthop Disord

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Poncet's disease or tubercular rheumatism is uncommon, and there are not many related studies. No consensus has been achieved with respect to its etiopathogenesis. The low prevalence of this Poncet's disease even in endemic regions suggests hidden mechanisms that require further research to fully comprehend this enigmatic disorder. Careful identification of primary focus of tubercular infection, clinical suspicion and knowledge of this disorder is crucial for prompt identification and treatment. This article aims to provide an overview of the recently published articles about Poncet's disease. The article attempts to highlight key features of the disease for better understanding of this peculiar disorder.

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Disseminated tuberculosis associated with reactive arthritis of Poncet in an immunocompetent patient

Cited by 5 publications

References 10 publications

Dactylitis and Ungual Tuberculosis: An Atypical Presentation of the Disease

Dactylitis and Ungual Tuberculosis: An Atypical Presentation of the Disease

Reactive Arthritis Update: Spotlight on New and Rare Infectious Agents Implicated as Pathogens

Poncet′s disease (tubercular rheumatism): a narrative review

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