Aseptic arthritis in a man with toxic shock syndrome

Association between high antistaphylolysin and teichoic acid antibody titres with rheumatic syndromes

To analyse which rheumatic syndromes are associated with serological evidence of recent Staphylococcus aureus infection, we studied retrospectively 44 adult patients, gathered between 1979-1990, having an acute arthritis syndrome or an exacerbation in their chronic rheumatic disease and simultaneously a high antistaphylolysin (ASTA > 4,0) and/or high teichoic acid antibody titre (TAA > 8). Patients with septic arthritis or endoprosthetic infections were not included. 25 patients had arthritis/arthralgia associated with a known rheumatic disease, 9 patients had reactive arthritis and 8 patients had arthralgia. The frequency of HLA-B27 in tested patients was significantly higher in the whole patient group than in the healthy Finnish population (43% v 14%, p < 0.001). It is concluded that high ASTA and/or TAA titres are associated with various acute rheumatic syndromes including reactive arthritis.

Infection-related arthritis

Postinfection arthritis represents a significant portion of the referrals to pediatric rheumatology centers, particularly in the United States. Many viral and common bacterial infections can be associated with arthritis, and their recognition can sometimes be difficult on a clinical basis. In patients with acute onset of arthritis, the clinician should actively seek epidemiologic, clinical, or laboratory evidence of infection. Diagnostic tests should be used rationally and results interpreted carefully. Some infections, once recognized, require antibiotic treatment, but in most cases anti-inflammatory therapy is successful in treating articular symptoms.

Staphylococcus aureus triggered reactive arthritis

OBJECTIVES

To report two patients who developed reactive arthritis in association with Staphylococcus aureus infection.

METHODS

A review of the case notes of two patients.

RESULTS

Two adult female patients have developed sterile arthritis in association with Staph aureus infection. The first patient has had two episodes of arthritis; the first followed olecranon bursitis, the second followed infection of a central venous catheter used for dialysis. The second patient developed sterile arthritis while being treated for pyomyositis. Both patients had a self limited arthritis and were HLA-B27 negative.

CONCLUSION

Reactive arthritis may rarely follow Staph aureus infection. HLA-B27 negativity may be associated with a self limited arthritis in these cases.