title: Aseptic arthritis in a man with toxic shock syndrome.
abstract: Synovitis in toxic shock syndrome (TSS) is an unusual finding. A 31-year-old man presented with pain and swelling in both knees and was found to have TSS, secondary to a septic bursitis caused by Staphylococcus aureus. Immune complexes were not detected in serum or synovial fluid, and the S aureus was not recovered from the inflamed joints. Antibodies against the TSS toxin-1 were detected in serum and synovial fluid, but in lower levels than would be seen in a normal control serum. Complement studies implicated alternative pathway activation by a marked diminution in C3 levels compared with C4 levels, and by lower levels of factor B than would be found in other inflammatory joint diseases. The diagnostic dilemma posed by TSS in a man is discussed.
mesh_terms: D000328:Adult; D000906:Antibodies / Q000032:analysis; D001168:Arthritis / Q000097:blood / Q000150:complications*; D003165:Complement System Proteins / Q000032:analysis; D006801:Humans; D007136:Immunoglobulins / Q000032:analysis; D008297:Male; D012772:Shock, Septic / Q000097:blood / Q000150:complications* / Q000276:immunology; D013203:Staphylococcal Infections / Q000150:complications
chemical_list: D000906:Antibodies; D007136:Immunoglobulins; D003165:Complement System Proteins