Infection-Related Arthritis Flashcards
How is infectious arthritis diagnosed?
Isolation of the pathogen by culture or PCR from synovial fluid or blood.
What is the mainstay of treatment for infectious arthritis?
Drainage and lavage of the joint space and antimicrobial therapy (unless viral) targeted toward the inciting organism.
List four microbes that commonly cause arthritis.
S. aureus (most common), N. gonorrhoeae, Parvovirus B19, and HBV.
Infections of which two systems typically occurs prior to reactive arthritis?
GI or GU
What is the typical temporal relationship between the onset of reactive arthritis and the infection which incited it?
Reactive arthritis typically occurs 1-4 weeks after the inciting infection.
List 6 GI pathogens which have been implicated in the development of reactive arthritis.
Yersinia, Shigella, Salmonella, Campylobacter, C. diff, and Giardia.
List 3 GU infections which have been implicated in the development of reactive arthritis.
Chlamydia, Lyme disease, and streptococcal infection.
What is the typical triad of reactive arthritis?
Reactive arthritis typically manifests as a triad of urethritis, conjunctivitis, and arthritis.
What is the “catch phrase” for remembering reactive arthritis?
Can’t pee, can’t see, can’t climb a tree (urethritis, conjunctivitis, and arthritis).
Can urethritis occur in reactive arthritis if the organism is of GI origin?
Yes. Urinalysis may show a sterile pyuria.
What are some common mucocutaneous features of reactive arthritis?
Oral ulcers, genital ulcers, and papular skin lesions.
How long does the arthritis typically last in patients diagnosed with reactive arthritis?
The arthritis usually lasts 3-6 weeks, but can occasionally be chronic.
What is the recommended treatment for reactive arthritis?
NSAIDs. Resistant cases may benefit from sulfasalazine, methotrexate, and/or anti-TNF agents.
In infectous arthritis, what are the differing characteristics between bacterial and viral etiologies?
Bacteria tend to involve single, large joints, although certain pathogens (especially S. aureus and N. gonorrhoae) can affect multiple joints. Viral etiologies cause a rash and commonly have symmetric involvement of smaller joints.
