Abstract
Purpose of review: This article presents a comprehensive narrative review of reactive arthritis (ReA) with focus on articles published between 2018 and 2020. We discuss the entire spectrum of microbial agents known to be the main causative agents of ReA, those reported to be rare infective agents, and those reported to be new candidates causing the disease. The discussion is set within the context of changing disease terminology, definition, and classification over time. Further, we include reports that present at least a hint of effective antimicrobial therapy for ReA as documented in case reports or in double-blind controlled studies. Additional information is included on microbial products detected in the joint, as well as on the positivity of HLA-B27.
Recent findings: Recent reports of ReA cover several rare causative microorganism such as Neisseria meningitides, Clostridium difficile, Escherichia coli, Hafnia alvei, Blastocytosis, Giardia lamblia, Cryptosporidium, Cyclospora cayetanensis, Entamoeba histolytica/dispar, Strongyloides stercoralis, β-haemolytic Streptococci, Mycobacterium tuberculosis, Mycoplasma pneumoniae, Mycobacterium bovis bacillus Calmette-Guerin, and Rickettsia rickettsii. The most prominent new infectious agents implicated as causative in ReA are Staphylococcus lugdunensis, placenta- and umbilical cord-derived Wharton’s jelly, Rothia mucilaginosa, and most importantly the SARS-CoV-2 virus. In view of the increasingly large spectrum of causative agents, diagnostic consideration for the disease must include the entire panel of post-infectious arthritides termed ReA. Diagnostic procedures cannot be restricted to the well-known HLA-B27-associated group of ReA, but must also cover the large number of rare forms of arthritis following infections and vaccinations, as well as those elicited by the newly identified members of the ReA group summarized herein. Inclusion of these newly identified etiologic agents must necessitate increased research into the pathogenic mechanisms variously involved, which will engender important insights for treatment and management of ReA.
Keywords: Antimicrobial therapy; COVID-19 virus; HLA-B27; Reactive arthritis; Vaccination.
【저자키워드】 vaccination, COVID-19 virus, HLA-B27, Antimicrobial therapy, Reactive arthritis, 【초록키워드】 COVID-19, Treatment, Arthritis, Placenta, Tuberculosis, Infection, diagnostic, SARS-CoV-2 virus, classification, antimicrobial, Case report, management, cryptosporidium, Research, COVID-19 virus, HLA-B27, Antimicrobial therapy, case reports, information, disease, pathogenic mechanism, Mycobacterium tuberculosis, Mycoplasma pneumoniae, Vaccinations, Reactive arthritis, Escherichia coli, Staphylococcus, Mycobacterium bovis, microbial, double-blind, Clostridium difficile, focus, can not, diagnostic procedures, infectious agent, Bacillus Calmette-Guérin, Definition, candidate, article, terminology, pathogenic mechanisms, Clostridium, infective, microbial products, recent, effective, reactive, arthritides, Cyclospora cayetanensis, Entamoeba histolytica, entire spectrum, Giardia lamblia, joint, Rickettsia rickettsii, Strongyloides stercoralis, include, involved, reported, the disease, form, elicited, implicated, increasingly, arthritide, Entamoeba, microbial product, the SARS-CoV-2 virus, umbilical, 【제목키워드】 Reactive arthritis, agent, New,