Osteoarticular infectious complications in patients with primary immunodeficiencies.
OBJECTIVE
To describe the incidence and management of various infectious arthritides in selected primary immunodeficiency states.


RESULTS
Joint complications have been a well recognized finding in patients with primary immunodeficiencies for many years. Many are clearly infectious in etiology, but other apparently noninfectious joint abnormalities similar to rheumatoid arthritis have been shown to be due to an underlying infectious trigger. In humoral immunodeficiencies such as common variable immunodeficiency and X-linked agammaglobulinemia, bacterial organisms are the most common causes of infectious arthritis, but mycoplasmas and ureaplasmas are also of particular importance. In nonhumoral immunodeficiencies, noninfectious inflammatory arthritides are more prevalent, although microbiologic organisms have been reported in some cases of arthritis. Lack of appropriate culturing techniques and documentation of infectious agents may underestimate the prevalence of low-virulence infections in these patients.


CONCLUSIONS
Infectious arthritis is a significant comorbidity associated with primary immunodeficiencies and can be the presenting feature for some patients. Prompt examination for common as well as atypical organisms is not only important for the treatment but also crucial to the understanding of the exact etiology of arthritides as a whole in these disorders.
The Mount Sinai Medical Center, New York, NY 10029, USA.
Katherine A
KA
Bloom
Danna
D
Chung
Charlotte
C
Cunningham-Rundles
D001168:Arthritis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000150:complications*; D015994:Incidence