title: Reactive arthritis following Salmonella infection: a population-based study.
abstract: OBJECTIVE
  To study the incidence and clinical picture of Salmonella-associated reactive arthritis (ReA), as well as other reactive musculoskeletal symptoms and the arthritogenicity of various Salmonella enterica ssp. enterica serotypes in the population.
  
  
  METHODS
  We sent a questionnaire on enteric and extraintestinal (especially musculoskeletal) symptoms to 999 consecutive subjects with a Salmonella-positive stool culture. Analysis of self-reported musculoskeletal symptoms was supplemented with a clinical examination of subjects with recent symptoms.
  
  
  RESULTS
  Of the 999 Salmonella-positive subjects, 496 (50%) returned the questionnaire. Of these, 4.4% (22/496) had ReA and 13.7% (68/496) had other reactive musculoskeletal symptoms [tendinitis, enthesopathy, or bursitis (ReTe)]. Among the ReA patients, all adults, Salmonella Enteritidis was the most common causative serotype. The clinical picture of patients with ReA was mostly monoarticular or oligoarticular. Human leucocyte antigen (HLA)-B27 was positive in 42% of patients with ReA. The Salmonella O antigens of the 496 subjects belonged to eight groups (B, C, D1, E, G, I, L, and O), all with different major O antigenic determinants. All 22 patients with ReA and all 68 patients with ReTe were in O antigen groups B, C, D1, or E. However, the occurrence of musculoskeletal complications showed no statistically significant difference in relation to different O antigen groups (p = 0.69).
  
  
  CONCLUSIONS
  ReA occurred in 4.4% of patients after Salmonella infection, with an annual incidence of 1.8/100,000 in Finland. We found no differences in arthritogenicity between different Salmonella serotypes that trigger musculoskeletal complications.
authors: Division of Rheumatology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland. riitta.tuompo@hus.fi
authors: R
authors: R
authors: Tuompo
authors: T
authors: T
authors: Hannu
authors: L
authors: L
authors: Mattila
authors: A
authors: A
authors: Siitonen
authors: M
authors: M
authors: Leirisalo-Repo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D016918:Arthritis, Reactive / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D000091402:Prohibitins; D012475:Salmonella / Q000472:pathogenicity*; D012480:Salmonella Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D012703:Serotyping; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; C000717331:PHB2 protein, human; D000091402:Prohibitins