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Reactive arthritis: clinical aspects and medical management.

Rheum Dis Clin North Am. 2009 Feb;35(1):21-44

Authors: Carter JD, Hudson AP

Reactive arthritis (ReA) is an inflammatory arthritis that arises after certain gastrointestinal or genitourinary infections, representing a classic interplay between host and environment. It belongs to the group of arthritidies known as the spondyloarthropathies. The classic syndrome is a triad of symptoms, including the urethra, conjunctiva, and synovium; however, the majority of patients do not present with this triad. Diagnostic criteria for ReA exist, but data suggest new criteria are needed. Epidemiologic and prospective studies have been difficult to perform because of over-reliance on the complete classic triad of symptoms and the different terms and eponyms used. Studies assessing various treatment strategies are ongoing.

PMID: 19480995 [PubMed - indexed for MEDLINE]

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Pathophysiology and clinical spectrum of infections in systemic lupus erythematosus.

Rheum Dis Clin North Am. 2009 Feb;35(1):75-93

Authors: Cuchacovich R, Gedalia A

Systemic lupus erythematosus (SLE) is an inflammatory and multisystemic autoimmune disorder characterized by an uncontrolled autoreactivity of B and T lymphocytes leading to the production of autoantibodies against self-directed antigens and tissue destruction. Environmental factors, such as infections, which are an important cause of morbidity and mortality, are potential triggers of the disease. This article discusses bacterial, viral, and opportunistic microorganism infections in SLE, and the role of immunosuppressive therapy and immunodeficiencies in the disease.

PMID: 19480998 [PubMed - indexed for MEDLINE]

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Gonococcal and nongonococcal arthritis.

Rheum Dis Clin North Am. 2009 Feb;35(1):63-73

Authors: García-De La Torre I, Nava-Zavala A

Acute bacterial arthritis usually is caused by gonococcal or nongonococcal infection of the joints. Nongonococcal and gonococcal arthritis are the most potentially dangerous and destructive forms of acute arthritis. These bacterial infections of the joints are usually curable with treatment, but morbidity and mortality are still significant in patients who have underlying rheumatoid arthritis, patients who have prosthetic joints, elderly patients, and patients who have severe and multiple comorbidities. This article reviews the risk factors, pathogenesis, clinical manifestations, diagnosis, and treatment of nongonococcal and gonococcal arthritis.

PMID: 19480997 [PubMed - indexed for MEDLINE]

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Soft tissue infections.

Rheum Dis Clin North Am. 2009 Feb;35(1):45-62

Authors: Torralba KD, Quismorio FP

Soft tissue infections are common and potentially fatal conditions. Infections are a major cause of morbidity and mortality in patients who have rheumatic disease. Patients who have rheumatic diseases may be at increased risk for soft tissue infections because of various factors, including inherent immunologic defects, genetics, and use of immunomodulatory therapy, including biologic agents. Timely diagnosis and management with the institution of antibiotics with or without surgical intervention is imperative for effective resolution of infection. This article provides a review of recent literature on the presentation and clinical course of infectious tenosynovitis, septic bursitis, pyomyositis, and necrotizing fasciitis, especially in relation to patients who have rheumatic disease.

PMID: 19480996 [PubMed - indexed for MEDLINE]

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