Unusual causes of reactive arthritis: Leptospira and Coxiella burnetii.
Reactive arthritis is a well-defined clinical syndrome occurring after various infections, although most cases are usually associated with Chlamydiae and gastrointestinal pathogens. Its immunologic background has been extensively studied, as has its relationship with HLA-B27. We describe two cases of reactive arthritis arising after infections with two pathogens not so far related to the occurrence of reactive arthritis: one patient exhibited migratory oligoarthritis shortly after the course of acute Q fever, and another patient developed monoarthritis during recovery from leptospirosis. Arthritis was transient and did not exhibit a chronic course in either patient. We further discuss the context of pathophysiology of the arthritis in these patients, with an emphasis on the immunomodulatory properties of these two pathogens.
University Hospital of Ioannina, Ioannina, Greece. gpele@otenet.gr
G
G
Pappas
N
N
Akritidis
L
L
Christou
M
M
Mastora
E
E
Tsianos
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D016918:Arthritis, Reactive / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D016997:Coxiella burnetii / Q000302:isolation & purification; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007919:Leptospira / Q000302:isolation & purification; D007922:Leptospirosis / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D010147:Pain Measurement / Q000187:drug effects; D011778:Q Fever / Q000150:complications* / Q000175:diagnosis; D016059:Range of Motion, Articular / Q000502:physiology; D018570:Risk Assessment; D012720:Severity of Illness Index; D013752:Tetracycline / Q000627:therapeutic use; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D013752:Tetracycline