PDF(Pubmed)
Abstract：
With an annual incidence of 250-300 per 100,000 inhabitants, reactive arthritis is not uncommon. However, the fact that Clostridioides difficile infection (CDI) can also lead to this complication is largely unknown. We report on a 69-years-old man who developed reactive arthritis of his right knee joint one week after antibiotic-associated diarrhea with evidence of C. difficile of the hypervirulent ribotype 027. His female partner also became infected with C. difficile ribotype 027, but did not develop reactive arthritis. The further investigation showed that the patient - in contrast to his partner - was HLA-B27 positive and had strong antibody levels against C. difficile. The case history together with the review of 45 other cases described so far shows that C. difficile can also lead to reactive arthritis. C. difficile-associated reactive arthritis (CDARA) is characterized by the fact that patients suffer from diarrhea or colitis after taking antibiotics, toxigenic C. difficile or only the toxins are detectable in the stool and there are no other explanations for the arthritis and diarrhea.
摘要：
每10万居民每年发生250-300例，反应性关节炎并不少见。然而,艰难梭菌感染(CDI)也可能导致这种并发症的事实在很大程度上是未知的.我们报道了一名69岁的男子，该男子在抗生素相关性腹泻一周后出现了右膝关节反应性关节炎，并有证据表明具有高毒性抗体型027的艰难梭菌。他的女性伴侣也感染了艰难梭菌病毒型027，但没有发展为反应性关节炎。进一步的调查显示，与他的伴侣相反，患者是HLA-B27阳性，并且具有针对艰难梭菌的强抗体水平。病例史以及迄今为止描述的45例其他病例的回顾表明艰难梭菌也可导致反应性关节炎。艰难梭菌相关反应性关节炎（CDARA）的特点是患者在服用抗生素后出现腹泻或结肠炎，在粪便中可以检测到产毒艰难梭菌或只有毒素，并且对于关节炎和腹泻没有其他解释。
