Infeccion Y Artritis

Eular On-line Course on Rheumatic Diseases – module n°11 Marjatta Leirisalo-Repo, Ben A. Dijkmans, Kari K. Eklund

INFECTION AND ARTHRITIS
Marjatta Leirisalo-Repo, Ben A. Dijkmans, Kari K. Eklund

LEARNING OBJECTIVES

• • • • • • • • •

Distinguish between infectious arthritis and inflammatory arthritis Diagnose and treat reactive arthritis Diagnose and treat Lyme arthritis Treatinfectious (septic) arthritis Diagnose and treat viral arthritides Diagnose and treat musculoskeletal symptoms during HIV infection Diagnose and treat arthritis associated with hepatitis C infection Make differential diagnosis between C hepatitis arthritis and rheumatoid arthritis Consider the role of infections in the propagation of chronic rheumatic diseases

1
©2007 EULAR

Eular On-line Courseon Rheumatic Diseases – module n°11 Marjatta Leirisalo-Repo, Ben A. Dijkmans, Kari K. Eklund

CONTENTS I INTRODUCTION

II BACTERIAL INFECTIONS AND ACUTE ARTHRITIS II-1 Septic Arthritis II-1-1 Non-gonococcal arthritis II-1-1-1 Occurrence II-1-1-2 Clinical symptoms and diagnosis II-1-1-3 Treatment II-1-1-4 Outcome II-1-2 Gonococcal arthritis II-1-2-1 Occurrence II-1-2-2 Clinical symptoms anddiagnosis II-1-2-3 Treatment II-1-2-4 Outcome II-2 Reactive Arthritis II-2-1 Triggering infections II-2-2 Epidemiology of reactive arthritis II-2-3 Genetic component in reactive arthritis II-2-4 Pathogenesis of reactive arthritis II-2-5 Clinical symptoms and diagnosis II-2-5-1 Symptoms II-2-5-2 Laboratory diagnosis II-2-6 Treatment II-2-6-1 Treatment of the triggering infection II-2-6-2 Treatment ofarthritis II-2-7 Outcome II-2-8 Reactive arthritis after upper respiratory infection II-3 Lyme Arthritis II-3-1 Epidemiology of Lyme disease II-3-2 Clinical features in Lyme disease II-3-2-1 Lyme arthritis II-3-2-2 Diagnosis of Lyme disease II-3-2-3 Treatment of Lyme arthritis

2
©2007 EULAR

Eular On-line Course on Rheumatic Diseases – module n°11 Marjatta Leirisalo-Repo, Ben A. Dijkmans,Kari K. Eklund

III VIRAL CAUSES OF ARTHRITIS III-1 Parvovirus III-1-1 Clinical picture and diagnosis of parvovirus arthritis III-1-2 Treatment of parvovirus arthritis III-2 Rubella III-2-1 Clinical picture and diagnosis of rubella arthritis III-2-2 Treatment of rubella arthritis III-3 Alphavirus Arthritis III-3-1 Clinical picture and diagnosis of alphavirus arthritis III-4 HIV and ArthritisIII-4-1 HIV arthritis III-4-2 Reactive arthritis in patients infected with HIV III-4-3 Arthritis in the HAART era III-5 Hepatitis C and Arthritis III-5-1 Clinical symptoms of arthritis associated with hepatitis C III-5-2 Differential diagnosis between rheumatoid arthritis and hepatitis C arthritis III-5-3 Pathogenesis III-5-4 Treatment of hepatitis C arthritis

IV INFECTIONS IN THE AETIOLOGY OFCHRONIC RHEUMATIC DISEASES IV-1 Whipple’s Disease IV-1-1 Pathogenesis IV-1-2 Clinical picture IV-1-3 Diagnosis IV-1-4 Treatment IV-2 Is Rheumatoid Arthritis Caused by Infection? IV-2-1 Epstein-Barr virus infection IV-3 Is Ankylosing Spondylitis caused by Infection? IV-3-1 Bacteria and ankylosing spondylitis IV-4 Are Spondyloarthritides caused by Infection?

SUMMARY

3
©2007 EULAR

Eular On-lineCourse on Rheumatic Diseases – module n°11 Marjatta Leirisalo-Repo, Ben A. Dijkmans, Kari K. Eklund

I INTRODUCTION In the case of a patient presenting with acute arthritis, infectious causes are often suspected but the possibility of infection has also to be kept in mind in the case of chronic arthritis. Especially in a patient with acute painful monoarthritis with fever, infectious causes ofarthritis should be searched for. Septic arthritis is uncommon, but a high suspicion and early treatment is important. In addition to acute septic arthritis, infection if often suspected in the case of a patient is presenting with recent mono-, oligo- or polyarthritis. Furthermore, infection may induce a chronic arthritis or precipitate a flare of chronic established rheumatic disease.

In...