Streptococcal Reactive Arthritis
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.
BIBLIOGRAPHY
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
