Reactive arthritis following an outbreak of Salmonella typhimurium phage type 193 infection.
OBJECTIVE
To determine the occurrence and the clinical picture of reactive arthritis (ReA) following an outbreak of Salmonella typhimurium.


METHODS
An outbreak of S typhimurium phage type DT 193 occurred in several municipalities in Finland in 1999. A questionnaire which had a specific emphasis on musculoskeletal symptoms was mailed to all 78 subjects with a positive stool culture. Based on the answers, all subjects with recent joint complaints were clinically examined or interviewed by telephone.


RESULTS
Sixty three of 78 subjects (81%) returned the questionnaire. Of these 63 subjects, five (8%) fulfilled the criteria for ReA. All the five subjects with ReA were adults with oligo- or polyarthritis. The antigen HLA-B27 was positive in two of the four subjects tested. In two of five subjects with ReA, the duration of acute arthritis was over six months. Subjects who had received antimicrobial drugs developed acute musculoskeletal symptoms significantly (p=0.013) less often than those without such treatment. None of the subjects with ReA had received antimicrobial drugs before the onset of joint symptoms.


CONCLUSIONS
The occurrence of ReA following an outbreak of S typhimurium was at the same level as in outbreaks due to other salmonella serotypes reported previously by us, indicating that the frequency of ReA after various outbreaks is approximately 10%. Early use of antimicrobial drugs may prevent the development of musculoskeletal symptoms.
Hannu
T
T
Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital, Finland. thannu@nettilinja.fi
Mattila
L
L
Siitonen
A
A
Leirisalo-Repo
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D016918:Arthritis, Reactive / Q000188:drug therapy / Q000209:etiology*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D024841:Fluoroquinolones; D015796:HLA-B27 Antigen / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D000091402:Prohibitins; D012480:Salmonella Infections / Q000150:complications* / Q000188:drug therapy; D012483:Salmonella Phages; D012486:Salmonella typhimurium / Q000821:virology; D018709:Statistics, Nonparametric
D000890:Anti-Infective Agents; D024841:Fluoroquinolones; D015796:HLA-B27 Antigen; C000717331:PHB2 protein, human; D000091402:Prohibitins