title: Chlamydia pneumoniae arthritis in a patient with common variable immunodeficiency.
abstract: BACKGROUND
  Arthritis is an important and sometimes life-threatening complication in patients with common variable immunodeficiency (CVID).
  
  
  OBJECTIVE
  To describe a patient with CVID and arthritis due to Chlamydia pneumoniae, which is usually regarded as a respiratory tract pathogen and has not previously been detected in the synovial fluid by cell culture technique.
  
  
  METHODS
  Routine bacteriologic, virologic, mycologic, and tuberculosis cultures were performed. The patient's synovial fluid was examined for fastidious organisms that might be causative pathogens of arthritis, such as chlamydiae, and special cell culture methods were used. Serologic tests were performed to determine viral and bacteriologic etiology.
  
  
  RESULTS
  The patient had a history of recurrent respiratory tract infections, and the latest exacerbation was followed by arthritis. Cytologic examination of the fluid yielded abundant lymphocytes. Chlamydia pneumoniae was detected in synovial fluid specimens by cell culture technique. Her nasopharyngeal swab and sputum culture specimens were also positive for this pathogen. She was diagnosed as having arthritis caused by C pneumoniae and was given antibiotherapy.
  
  
  CONCLUSIONS
  Chlamydia pneumoniae should be kept in mind as a causative pathogen in patients with CVID and arthritis, especially when effusion fluid is full of lymphocytes rather than polymorphonuclear cells and no organism is grown on routine cultures.
authors.affiliation: Department of Internal Medicine, Ege University Medical Faculty, Izmir, Turkey. oardeniz@med.ege.edu.tr
authors.forename: Omür
authors.initials: O
authors.lastname: Ardeniz
authors.forename: Okan
authors.initials: O
authors.lastname: Gülbahar
authors.forename: Nihal
authors.initials: N
authors.lastname: Mete
authors.forename: Candan
authors.initials: C
authors.lastname: Ciçek
authors.forename: Ozen Kaçmaz
authors.initials: OK
authors.lastname: Başoğlu
authors.forename: Aytül
authors.initials: A
authors.lastname: Sin
authors.forename: Ali
authors.initials: A
authors.lastname: Kokuludağ
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001168:Arthritis / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology* / Q000473:pathology; D002690:Chlamydia Infections / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology / Q000473:pathology; D016993:Chlamydophila pneumoniae / Q000254:growth & development*; D017074:Common Variable Immunodeficiency / Q000382:microbiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007717:Knee / Q000382:microbiology / Q000473:pathology; D013582:Synovial Fluid / Q000382:microbiology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal