[Reactive arthritis due to Clostridium difficile].
Extracolonic manifestations of Clostridium difficile infections have rarely been reported as a cause of reactive arthritis. We report the case of a monoarticular arthritis following pseudomembranous colitis. A 45 year-old man was admitted for fever and monoarthritis of the left knee, 8 days after the onset of a C. difficile enterocolitis associated with urethritis. Samples obtained from the knee, urine, and blood cultures remained sterile. Bone scintigraphy revealed a left knee and forefoot hyperfixations. The association of arthritis and urethritis led us to the diagnosis of Fiessinger-Leroy-Reiter syndrome. Antibiotics for arthritis were ineffective and stopped, but they were continued for colitis. NSAIDs were prescribed and clinical manifestations disappeared within 24 hours, the patient resumed walking after 48 hours. Four months later there was no relapse and no sequela.
Service des maladies infectieuses et tropicales, CHU Dupuytren, 2, 87042 Limoges cedex, France.
S
S
Ducroix-Roubertou
C
C
Genet
J P
JP
Rogez
P
P
Weinbreck
E
E
Denes
D000038:Abscess / Q000188:drug therapy; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D016918:Arthritis, Reactive / Q000000981:diagnostic imaging / Q000209:etiology* / Q000382:microbiology; D002981:Clindamycin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D016360:Clostridioides difficile / Q000302:isolation & purification*; D004240:Diverticulum / Q000601:surgery; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000627:therapeutic use; D004761:Enterocolitis, Pseudomembranous / Q000150:complications*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging; D008875:Middle Aged; D010397:Penicillanic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D010878:Piperacillin / Q000008:administration & dosage / Q000627:therapeutic use; D000077725:Piperacillin, Tazobactam Drug Combination; D011183:Postoperative Complications / Q000188:drug therapy / Q000382:microbiology; D011877:Radionuclide Imaging; D012810:Sigmoid Diseases / Q000601:surgery; D014526:Urethritis / Q000150:complications
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000077725:Piperacillin, Tazobactam Drug Combination; D002981:Clindamycin; D010397:Penicillanic Acid; D010878:Piperacillin