Artrite Reativa após infecção por Giardia lamblia: um relato de caso

Abstract

Giardia sp. is one of the most common intestinal parasites in humans; during the first two years of life it is the main cause of intestinal parasitic infections. In addition to enteric symptoms, this parasitosis can be a trigger to extra-intestinal manifestations such as ophthalmic, dermatological, urinary tract and musculoskeletal symptoms. It is possible to include arthritis, which, associated to a post-enteropatic or genitourinary symptoms may characterize a Reactive Arthritis (ReA). Nevertheless, it stands out that an association with post-infectious arthritis is relatively scarce, and it’s believed that the secondary arthropathy to giardiasis can be sub diagnosed. The main goal of the present article is to report a case of synovitis associated to Giardia sp. We describe an, eighteen month old, with an acute right hip synovitis, treated with non-hormonal anti-inflammatory medication for five days, with improvement of symptoms. However, after 29 days, the child had similar presentation in the contra lateral joint, being treated again with non-hormonal anti-inflammatory medication. The parasitological examination was positive for Giardia Lamblia. After treatment, the symptoms resolved with the child remaining asymptomatic. It is necessary to include Giardia sp. on the etiological reasoning towards Reactive Arthritis, especially in cases of recurrence since the presentation of this disease is non-specific and prevalence is high in young children from developing countries.