title: Rickettsioses presenting as major joint arthritis and erythema nodosum: description of four patients.
abstract: Erythema nodosum and aseptic arthritis are recognized associations of rickettsial infections. However, they usually present with a febrile illness rather than with severe arthritis. We report three patients who presented with incapacitating major joint arthritis and one who presented with severe spondyloarthropathy in addition to major joint arthritis due to serologically confirmed Orientia tsutsugamushi and Rickettsia conorii infections. All of them had erythema nodosum and low-grade fever. They had rapid clinical response to doxycycline.
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Kelaniya, P.O. Box 6, Thalagolla Road, Ragama, Sri Lanka. ranjan_premaratna@lycos.com
authors.forename: R
authors.initials: R
authors.lastname: Premaratna
authors.forename: T G A N
authors.initials: TG
authors.lastname: Chandrasena
authors.forename: R P V J
authors.initials: RP
authors.lastname: Rajapakse
authors.forename: M E
authors.initials: ME
authors.lastname: Eremeeva
authors.forename: G A
authors.initials: GA
authors.lastname: Dasch
authors.forename: N K B K R G W
authors.initials: NK
authors.lastname: Bandara
authors.forename: H J
authors.initials: HJ
authors.lastname: de Silva