Polyarthrite réactionnelle à Clostridium difficile chez un enfant de 7ans

Dacheux, Charles; Pruvost, I.; Herbaux, B.; Nectoux, Éric

doi:10.1016/j.arcped.2012.03.011

Cited by 7 publications

(6 citation statements)

References 8 publications

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“…Research Original Investigation C difficile Infection-Associated Reactive Arthritis in Children ment for C difficile. 8,10,25 While disparate reported cases cannot be considered a representative sample, these clinical features are compatible with the few reported pediatric cases [15][16][17][18][19] and our own study's findings. In contrast with adults, children appear to have more frequent hip involvement and, associated with this, more dramatic clinical presentations that sometimes raise concerns for septic arthritis.…”

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

“…In contrast with adults, children appear to have more frequent hip involvement and, associated with this, more dramatic clinical presentations that sometimes raise concerns for septic arthritis. 16,17 Several children with CDIAReA in our cohort were diagnosed with serum sickness. Generally, this immune complexmediated disease presents within 1 to 2 weeks after antibiotic exposure as a symmetric arthritis of multiple joints accompanied by urticarial-like rash and angioedema.…”

Section: Discussionmentioning

confidence: 99%

“…Drainage procedures, even when performed outside the operating room, may provide symptomatic relief as well as fluid for analysis and culture. 16,17 However, for those with preceding (postantibiotic) diarrhea and migratory or multiple-site arthritis, CDIAReA can be presumed and closely monitored. In our study, CDIAReA was self-limited, usually resolving within 1 to 3 weeks after treatment for CDI.…”

Section: Discussionmentioning

confidence: 99%

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Epidemiology ofClostridium difficileInfection–Associated Reactive Arthritis in Children

et al. 2016

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IMPORTANCEThe incidence of Clostridium difficile infection has increased among children. The epidemiology of pediatric C difficile infection-associated reactive arthritis is poorly understood.OBJECTIVE To characterize the incidence, recognition, and distinguishing clinical features of pediatric C difficile infection-associated reactive arthritis among children with C difficile infection. DESIGN, SETTING, AND PARTICIPANTSIn this cohort and nested case-control study using electronic health records from January 1, 2004, to December 31, 2013, across 3 geographically diverse pediatric health care networks, we screened for reactive arthritis among 148 children between ages 2 and 21 years with diagnostic or procedural codes suggesting musculoskeletal disease associated with C difficile diagnosis or positive testing. We identified 26 cases with acute arthritis or tenosynovitis within 4 weeks before to 12 weeks after confirmed C difficile infection with (1) no alternative explanation for arthritis and (2) negative synovial cultures (if obtained). Network-matched C difficile-infected controls without arthritis were randomly selected at the time of cohort member C difficile infections. MAIN OUTCOMES AND MEASURESIncidence of C difficile infection-associated reactive arthritis was calculated based on (1) pediatric source population and (2) children with C difficile infection. Characteristics of cases and controls were compared using conditional logistic regression. RESULTSBased on the cases identified within the source population of the 3 hospital networks, we estimated that C difficile infection-associated reactive arthritis incidence was 5.0 cases per million person-years (95% CI, 3.0-7.8). Reactive arthritis affected 1.4% of children with C difficile infection yearly (95% CI 0.8%-2.3%). Joint symptoms began a median of 10.5 days after initial gastrointestinal symptoms, often accompanied by fever (n = 15 [58%]) or rash (n = 14 [54%]). Only 35% of cases of C difficile infection-associated reactive arthritis were correctly diagnosed by treating health care professionals (range across centers, 0%-64%). Five affected children (19%) were treated for presumed culture-negative septic hip arthritis despite having prior postantibiotic diarrhea and/or other involved joints. Compared with controls, cases of C difficile infection-associated reactive arthritis were less likely to have underlying chronic conditions (odds ratio [OR], 0.3; 95% CI, 0.1-0.8). Although all cases had community-onset C difficile infection and fewer comorbidities, they were more likely to be treated in emergency departments and/or hospitalized (OR, 7.1; 95% CI, 1.6-31.7).CONCLUSIONS AND RELEVANCE C difficile infection-associated reactive arthritis is an underdiagnosed, potentially morbid reactive arthritis associated with C difficile infection occasionally misdiagnosed as septic arthritis. Given the rising incidence of pediatric C difficile infections, better recognition of its associated reactive arthritis is needed.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Epidemiology ofClostridium difficileInfection–Associated Reactive Arthritis in Children

et al. 2016

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“…Table 1 shows details regarding these reports on CD ReA in childhood. Cron and Gordon [ 3 ] described the first case in 1997 in the USA, and the second one was from the USA as well [ 4 ]; thereafter three children in France [ 5 , 6 ] and one child in the UK [ 7 ] were diagnosed with CD ReA. The median age was 6.5 years (range 2.5–11) and there was no age difference between males and females.…”

Section: Discussionmentioning

confidence: 99%

Clostridium difficileEnterocolitis and Reactive Arthritis: A Case Report and Review of the Literature

Cappella

Pugliese

Zucchini

et al. 2016

Case Reports in Pediatrics

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Reactive arthritis is a rare complication of Clostridium difficile enterocolitis, especially in children. We review the 6 pediatric cases published in the English and non-English literature and discuss their clinical presentation, outcome, treatment, and pathophysiology. We also report the seventh case of Clostridium difficile reactive arthritis in a 6-year-old boy who was treated with amoxicillin-clavulanate for 10 days because of an upper respiratory infection. After the antibiotic course, the child developed at the same time diarrhea with positive stool culture for Clostridium difficile and an asymmetric polyarthritis. Nonsteroidal anti-inflammatory drugs and metronidazole completely resolved the pain, joint swelling, and diarrhea. After twelve months of follow-up there has been no recurrence. This report confirms the self-limiting course of Clostridium difficile reactive arthritis. Clostridium difficile testing in children with gastrointestinal symptoms and acute onset of joint pain should be always considered.

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Arthrite réactionnelle à Clostridium difficile : à propos de 2 observations et revue de la littérature

Garrigues

Roux

Wanono

et al. 2016

La Revue de Médecine Interne

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Polyarthrite réactionnelle à Clostridium difficile chez un enfant de 7ans

Cited by 7 publications

References 8 publications

Epidemiology ofClostridium difficileInfection–Associated Reactive Arthritis in Children

Epidemiology ofClostridium difficileInfection–Associated Reactive Arthritis in Children

Clostridium difficileEnterocolitis and Reactive Arthritis: A Case Report and Review of the Literature

Arthrite réactionnelle à Clostridium difficile : à propos de 2 observations et revue de la littérature

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