BACTERIAL INVASION AS A KEY FACTOR IN PROGRESSION OF REACTIVE ARTHRITIS ON EXAMPLE OF CLINICAL CASE

Hany Osman ,Eugenia Golubkina ,Iryna Silenko ,M I Yabluchanskіy

doi:10.26565/2313-6693-2018-35-21

Abstract

A clinical case of middle age male diagnosed with reactive arthritis developed on the background of multiple bacterial invasions such as Salmonella enterica, Ureaplasma urealyticum, Mycoplasma hominis, Borrelia burgdorferi sensu lato and characterized by chronic persistent course of the disease with destructive-inflammatory changes in the joints. This case illustrates the influence of bacterial pathogens on the course and the progression of reactive arthritis. In our patient, reactive arthritis was charac-terized by a chronic persistent course with a constant increase in inflammatory markers and destructive-inflammatory changes in the joints.An important role in the progression of reactive arthritis in this patient played multiple bacterial invasions, which were not only a trigger of the onset of the disease, but also maintained a chronicity of the pathological processes.This clinical case is an illustration of the fact that infectious bacterial diseases play a key role in the pathogenesis of reactive arthritis, and repeated bacterial infections affect the course and progression of the disease, which leads to a significant disruption of the functionof the musculoskeletal system.It is important to treat the patient with avoidance of polypharmacy; this goal is achieved by the appointment of several basic drugs and a supportive therapy used in courses.

Highlights

Reactive arthritis (ReA) is a condition associated with bacterial infections of the urogenital and gastrointestinal tract, which trigger the onset of the disease, and play a role in the progression of pathological processes in the musculoskeletal system [1,2]
It was found that Salmonella infection correlated with a sufficiently high risk of chronic course of the disease: according to a 20-year study [2], Salmonella induced chronic reactive arthritis was observed in 19 % of cases
Reactive arthritis was characterized by a chronic persistent course with a constant increase in inflammatory markers and destructive-inflammatory changes in the joints

Summary

INTRODUCTION

Reactive arthritis (ReA) is a condition associated with bacterial infections of the urogenital and gastrointestinal tract, which trigger the onset of the disease, and play a role in the progression of pathological processes in the musculoskeletal system [1,2]. Was made the diagnosis of urogenital reactive arthritis and he was treated with doxycyclin, NSAIDS, dexamethasone His state has improved but still there was moderate pain and slight limitation of joint mobility. He had hospitalization with diagnosis: Lime’s disease (associated with Borrelia burgdorferi sensu lato), chronic course (26.12–15.01.13) After this the patient’s state worsened significantly – intensified pain in affected joints with enlargement, redness, restriction of movements; become affected left wrist joint, temperature increased up to 37,4°C. Diagnosis: Reactive arthritis (since 2010) associated with urogenital infection (ureaplasmosis, mycoplasmosis), chronic continuously-relapsing course, 2nd grade of activity, polyarthritis with knee joints lesions (bilateral gonarthrosis of 2nd degree), ankle joints lesions, hip joints lesions(right-sided coxarthrosis 4th grade, left-sided – 3d grade) , unilateral right-sided sacroileitis 2d grade, functional impairment 2 degree.

DISCUSSION

Findings

CONCLUSIONS

16. Sukumar Mukherjee Reactive Arthritis