Poststreptococcal reactive arthritis

Article Abstract:

Reactive arthritis is inflammation of the joints that is associated with an infection occurring at a distant site in the body. The inflamed joints are sterile, meaning they are not infected with the microorganisms causing the infection at the other site. Group A beta hemolytic streptococcal bacteria can cause such a reaction in the form of rheumatic fever, an inflammatory disease characterized by fever and joint disorders which is frequently followed by serious kidney and heart complications. Five cases are described of patients with sterile inflammation of the joints following streptococcal infection. Tests confirmed that the infections were caused by streptococcal bacteria, and in one case, by group A, beta hemolytic streptococci. All cases had an excellent outcome, although one patient required antibiotic therapy with penicillin for three months. The absence of heart inflammation and the successful treatment in these five patients suggested that the joint inflammation was associated with reactive arthritis and not with the more serious condition, rheumatic fever. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Beta haemolytic streptococci and reactive arthritis in adults

Article Abstract:

Adult reactive arthritis may be caused by group A beta hemolytic streptococci (BHS). Group A BHS are the bacteria that cause rheumatic fever in children. One study reviewed over 500 cases of rheumatic fever in adults since 1957. Only 32% of these patients had a history of rheumatic fever. An average of 92% of the adult patients with rheumatic fever developed polyarthritis, or inflammation of several joints together. These patients have usually developed arthritis in large weightbearing joints. Inflammation of the heart occurred in 33% of the adult patients with rheumatic fever. Several adults have developed post-streptococcal reactive arthritis (PSRA). PSRA is characterized by prolonged or recurrent episodes of arthritis and joint pain. Group G streptococci may also cause reactive arthritis in adults.

Physiological aspects, Arthritis

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Various rheumatic syndromes in adult patients associated with high antistreptolysin O titres and their differential diagnosis with rheumatic fever

Article Abstract:

Infection with beta hemolytic streptococci may be less likely to cause rheumatic fever than other types of reactive arthritis in adults. Rheumatic fever is one type of reactive arthritis caused by this type of bacteria. A study examined 76 adults with an arthritis syndrome or increased severity of a chronic rheumatic disease. All the patients had a simultaneous rise in blood levels of antistreptolysin O (ASO). ASO is an antibody that inhibits streptolysin, a toxin produced by group A streptococci. None of the patients were diagnosed with classic rheumatic fever despite elevated blood levels of ASO. Twenty-six patients were diagnosed with arthritis in association with a known rheumatic disease, 25 with non-specific joint and muscle pain, 20 with reactive arthritis and five with septic arthritis.

Diagnosis, Rheumatic fever

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