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Erlacher, L; Wintersberger, W; Menschik, M; Benke-Studnicka, A; Machold, K; Stanek, G; Söltz-Szöts, J; Smolen, J; Graninger, W.
Reactive arthritis: urogenital swab culture is the only useful diagnostic method for the detection of the arthritogenic infection in extra-articularly asymptomatic patients with undifferentiated oligoarthritis.
Br J Rheumatol. 1995; 34(9):838-842 Doi: 10.1093/rheumatology/34.9.838
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Leading authors Med Uni Graz
Graninger Winfried
Co-authors Med Uni Graz
Graninger Monika
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Abstract:
Reactive arthritis (ReA) is a seronegative oligoarthritis triggered by a preceding extra-articular infection. While evidence of a microbial infection is mandatory for establishing the diagnosis of ReA, the sensitivity of bacteriological and serological tests has not been determined in patients without symptoms of infection. In a retrospective study, we evaluated the usefulness of urogenital swab cultures, serology and stool culture to identify infections in 234 patients with undifferentiated oligoarthritis. One hundred and forty-four patients complaining about joint pain who had no sign or history of inflammatory arthritis served as controls. Urogenital swab cultures showed a microbial infection in 44% of the patients with oligoarthritis (15% Chlamydia, 14% Mycoplasma, 28% Ureaplasma), whereas in the control group only 26% had a positive result (4% Chlamydia, 7% Mycoplasma, 21% Ureaplasma) (P < 0.001). A Chlamydia IgG-antibody titre > or = 1:256 was found in 22% of the patients in the oligoarthritis group and in 9% of the controls (P < 0.01). However, for only half of Chlamydia IgG-positive patients could a Chlamydia infection be confirmed by urogenital swab culture. Twenty-one per cent of patients with oligoarthritis vs 23% of the controls had positive antibody titres for Salmonella (not significant), 15% vs 5% for Yersinia (P < 0.05) and 17% vs 3% for Borrelia IgG (P < 0.01). In two patients, stool cultures were positive for Campylobacter. Urogenital swab culture is a sensitive diagnostic method to identify the triggering infection in ReA. A single determination of antibodies against Chlamydia trachomatis is of limited value because of the high prevalence of positive results in the control group.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Arthritis, Reactive - diagnosis Arthritis, Reactive - immunology
Cytodiagnosis -
Feces - microbiology
Female -
HLA-B27 Antigen - analysis
Humans -
Male -
Middle Aged -
Serologic Tests -
Urethra - microbiology
Urogenital System - microbiology
Vaginal Smears -

Find related publications in this database (Keywords)
REACTIVE ARTHRITIS
OLIGOARTHRITIS
UROGENITAL SWAB CULTURE
SEROLOGY
STOOL CULTURE
CHLAMYDIA INFECTION
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