Streptococcal Reactive ArthritisDz

Last updated: October 31, 2014

Synonyms: Incomplete rheumatic fever, post-streptococcal arthritis.

ICD9 Code: 711.0
ICD10 Code:  M02.9

Etiology: Reactive arthropathy is caused by streptococcal infection (groups A and G).

Demographics: Streptococcal reactive arthritis is most common in children and young adults but also reported in adults.

Cardinal Findings: Onset follows streptococcal pharyngitis. Arthropathy (nonmigratory oligo- or polyarthritis) occurs within 2 weeks after a documented infection. Approximately one-third manifest episodic arthralgias or arthritis. Many develop systemic manifestations including fever, myalgias, prostration, and serositis.

Uncommon Findings: Few patients have developed carditis on long-term follow-up.

Diagnostic Tests: Most patients have an elevated antistreptolysin O or DNase
B antibody titer.

Keys to Diagnosis: Streptococcal reactive arthritis is distinguished from ARF by a lack of sufficient features to meet the Jones criteria. Classic cutaneous, cardiac, and neurologic findings of ARF are absent.

Therapy: Therapy is similar to that of ARF, but whether subsequent antibiotic prophylaxis is necessary is controversial.

Course: Characteristically, response to therapy with salicylates or NSAIDs is slow or incomplete. The course is often benign with a good outcome.

Deighton C. 13-Hemolytic streptococci and reactive arthritis in adults. Ann Rheum Dis 1993;52:475–482.PMID:8323403
Jansen TL, Janssen M, de Jong AJ, et al.. Post-streptococcal reactive arthritis: a clinical and serological description, revealing its distinction from acute rheumatic fever. J Intern Med 1999;245:261-267.PMID:10205588

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